Application form. Affiliate Delegate. DEADLINE: 22 June Access to Conference Hall

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Application form It s faster and easier to apply online; you can access the application form at: www.labevents.org/ac2018affiliatedelegate Before you start Affiliate Delegate Access to Conference Hall DEADLINE: 22 June 2018 Make sure you have all documents and information you may need to hand (passport, driving licence, Labour Party membership card, cheque book or credit card) You must complete all sections of the form carefully and accurately in BLOCK CAPITALS, writing one character in each square. The information provided may be used by the Labour Party and the police to carry out security checks. If any part does not apply to you, do not leave it blank but mark clearly in the first three boxes N / A (for not applicable ). If you have queries regarding your application please call Conference Services on 0345 092 3311 or email conferenceservices@labour.org.uk Type of pass: Affiliated organisations are entitled to appoint one delegate for each 5,000 members or part thereof on which affiliation fees, by election insurance premiums and any levies due were paid for the year ending 31 December 2017. Delegations should include women at least in the proportions in which they are represented in that organisation s membership. Where the membership of an affiliated trade union or other organisation is less than 5,000 members, an additional woman delegate may be appointed if the women s membership is 400 or more. Delegate type (please pass required): Up to 22 June From 22 June 31 Aug From 1 Sept onwards Trade Union Delegate 116 126 136 Socialist Society Delegate 116 126 136 Organisation you are representing: Includes 5 carbon offsetting charge

Previous attendance: Please tick any of the following Labour Party Annual Conferences that you have attended: Brighton, Annual Conference 2017 Liverpool, Annual Conference 2016 Brighton, Annual Conference 2015 Manchester, Annual Conference 2014 Personal details: Title Labour Party membership no. Forenames In full Surname Suffix Please indicate how you wish your name to appear on your pass Please indicate how you wish your organisation to appear on your pass Email address Home telephone Work telephone Mobile telephone Gender: Female Male Date of birth: / /. Pre-marital name Country of birth Nationality Town of birth Home address Previous address (if less than three years at current address) You must provide the last three years home addresses, if you have more than two please continue on a separate sheet Passport no. Driving licence

Mailing address: If you would like us to post your pass to a different address, please provide an alternative mailing address here: Photograph: You must supply a colour passport-style photograph of yourself, attached to your application form with a paper clip. Do not staple your photograph to the form. Photographs must comply with the following guidelines: printed on plain white photo-quality paper, not less than 600dpi resolution be in sharp focus, with no shadows on a light background show neutral expression, with mouth closed, and eyes open and clearly visible show head and shoulders in close-up, facing forwards, looking straight to camera show full head, without any covering, unless worn for religious beliefs If you normally wear glasses, you can wear them for your photograph but there must be no reflection from them. Disability requirements: All Labour Party Conferences are fully accessible. Please indicate below if you have any disability. We will contact you prior to Conference with details of facilities available to assist you at Conference. Wheelchair user Mobility impaired Hearing impaired Visually impaired Registered blind Other. Please give details Leader s Speech: The Leaders Speech to Conference will take place on the afternoon of Wednesday 26 September. Places are allocated to delegates and ex-officios.

Countersignature: Please nominate a UK resident who has known you for at least two years to be a countersignature for your application. Please note that you may not use a family member or partner for your countersignature. Your countersignature may be contacted by the Labour Party or the police to verify your identity, or confirm other information about you. It is your responsibility to get permission from your nominated countersignatory before submitting their details; failure to do so may result in your application being rejected. Relationship to applicant: Friend Colleague Neighbour Other CLP Secretary CLP Chair Surname Forename Gender: Male / Female Length of time known Years Months Home telephone Work telephone Mobile telephone Email address National Women s Conference: Please tick Closing Date 22 June Women s Conference Delegate (max. 25 per Affiliate 15 Organisation) Women s Conference Visitor 5 Following the successful policy debate at 2017 s conference, women s conference will again be inviting CLPs and affiliated organisations to send delegates. Each CLP is entitled to one delegate. The formal business of women s conference, including plenary speeches and policy debates will take place on Saturday 22 September. On Sunday 23 September there will be an exciting range of women s workshops and training on offer. You don t have to be delegate to attend - all women members are invited to join us in September at Labour s largest and most important women s event of the year. If you are interested in attending women s conference as a delegate, get in touch with your CLP secretary or affiliated organisation.

Payment: If your form is received without payment, or with the incorrect payment, it will not be processed. Please do not send cash in the post. I am enclosing (please complete): Pass fee National Women s Conference Total: (Please refer to page 1 & 4 for prices) I enclose a cheque payable to The Labour Party for the above amount OR Please charge my credit/debit card with the above amount: Cardholder name Card type Visa Mastercard Switch/Maestro American Express Card number Security code Expiry date / Start date / Issue number (if applicable) (if applicable) Invoicing address: Print name Work telephone Work address Work email Office use only:

Your signature: You must sign the form yourself in black ballpoint. If any of the information provided on this application is found to be incorrect you may be denied admission to Conference. I confirm that the above information is correct, to the best of my knowledge. Applicant s signature: Your rights and data protection: The completion and submission of this application does not confer any right upon the applicant to attend the conference, and the Labour Party reserves the right to refuse admission without giving a reason. The information provided by you may be supplied to the police for storage on a computer system in connection with policing arrangements for the event. The information may be retained and/or passed on to other police forces in the future to assist with the policing of subsequent conferences. The Labour Party and the Police will comply with the provisions of the Data Protection Act 2000 at all times in dealing with your data. Application forms, once processed, are retained by the Labour Party for reference for a period of five years, after which they will be securely destroyed. Deadlines/Cancellations: Applications correctly completed and received by 22 June 2018 will be processed and, subject to security checks, your pass will be mailed out to you in September. Due to the security checks required we are unable to guarantee that applications received after 22 June 2018 can be processed. Applications received after 22 June 2018 will incur additional charges as outlined and you may have to collect the pass in person at Conference. All deadlines will be strictly adhered to. Should you wish to cancel your application please inform Conference Services in writing; Any cancellations received up to and including 01 May 2018 will incur a 25% fee; cancellations received between 02 May and 31 August 2018 will incur a 50% fee; cancellations received after 01 September 2018 will not qualify for a refund. The full application fee will apply.

Carbon Emissions Fee: The Labour Party has shown consistent commitment towards tackling climate change, at home and abroad, by setting bold targets and pursuing ambitious policies, and working to secure long-term international agreement on reducing greenhouse gas emissions. Participants at our Annual Conferences pay a small fee towards compensating for their carbon emissions. Labour recognises that tackling the threat of climate change is one of the greatest challenges facing the world today. The payments we make to Natural Capital Partners from the carbon emission fee will help to fund projects for UK forest creation which will not only result in carbon emission reductions as the trees grow, but can also contribute to improved land management, flood prevention and the provision of more green spaces for communities. UK Forest Creation is managed in line with the Woodland Carbon Code to deliver the assurance that sites will be sustainably managed and deliver measurable carbon reductions. To find out more about Natural Capital Partners and UK Forest Creation please visit http://www.naturalcapitalpartners.com/solutions/solution/forestsuk Forest Creation please visit http://www.carbonneutral.com/our-services/uk-forest-creation Please return form to: Conference Services, The Labour Party, Labour Central, Kings Manor, Newcastle upon Tyne NE1 6PA Promoted by and on behalf of The Labour Party and reproduced from electronic media supplied by The Labour Party all at Southside, 105 Victoria Street, London, SW1E 6QT