Introduction

Important notice!

To be an eligible member of LPFT you must be over 12 years of age, other restrictions of membership can be found on pages 20-21 of the Trust Constitution.

If your circumstances change or if you have questions about our application form, please contact [email protected] or 01522 309176, where a member of the Membership team will be able to advise accordingly.

In this application, fields marked with * indicate that these are compulsory.

Member type*

Additional information

Title*

First Name*

Last Name*

Middle name

Address*

All applicants should include their address, so that we can ensure that they are listed under the correct public constituency

Postcode

Address Line 1

Address Line 2

Address Line 3

Address Line 4

Town or City

Postcode

Email*

Confirm email

Home telephone

Mobile