Volunteer

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Date:*

UDM Membership Number:*

Identity Number:*

First Name:*

Middle Name:

Last Name:*

Occupation:*

Physical/Home Address:*

Postal Address:*

Home Telephone:

Work Telephone:*

Fax:

Cell Number*

Email:*

Municipal Authority / Magisterial District:*

Ward:*

Branch Name:*

Region:*

Province:*

I would like to be involved in the organisational structure of the UDM*

YES
NO

I accept and understand that an annual membership fee of R10 will need to be paid by myself*

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UNITED DEMOCRATIC MOVEMENT VOLUNTEER FORM