FORM C-001

NAME OF APPLICANT

DATE OF BIRTH

ADDRESS

TELEPHONE

EMPLOYER

JOB DESCRIPTION

ARE YOU A REGISTERED VOTER

ARE YOU A MEMBER OF A CONSTITUENCY BRANCH?

Yes No

IF YES WHAT'S THE NAME?

ARE YOU INTERESTED IN JOING A GROUP?

IF YES CHOOSE AN OPTION

Central Youth for Labour Women Action Group Constituency Branch

I HEREBY DECLARE that I have no affiliations, associations, or memberships with any other political organization within the State of Antigua and Barbuda. I FURTHER PLEDGE to adhere to and uphold the rules and regulations governing the Antigua and Barbuda Labour Party. I COMMIT to abiding at all times by the Party’s Creed, recognizing the preeminence of the State and the inviolability of the Party’s Constitution and Conventions. I confirm that the above declaration is true and accurate, and I accept these terms as a condition of my membership.

ABLP Membership Application