Please print this form, and complete and return it with your cheque or standing order mandate to: BBC Pensioners' Association, Membership Secretary, PO Box 230, Alton GU34 9AR

Mr/Mrs/Miss/Ms/Other …………    First Name ………………………….........
Surname ………………………………………...................................................
Address …………………………………………………………………............
……………………………………………………………………………..........
Postcode ……………….........    BBC Pension No. ……………….....................
Tel. No. ………………………… Email ……………………………………
Date of Birth ……………………….

Signature ………………………………................   Date …………………........

Annual Subscription   £10.00 (May-April)   Joint Membership £15.00 (May-April)
Life Membership (if over 80) £50.00

Cheques should be made payable to 'BBC Pensioners' Association' OR , if you would prefer to pay by standing order, please complete the details below. We will forward this to your bank once we have noted the information.

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STANDING ORDER MANDATE
To:
…………………………………………………... Bank plc. (Your bank)
…………………………………………………... Branch (Your branch)
Address ………………………………………………………………….
……………………………………………………………………………
Postcode …………………

Please pay £10.00 immediately and then annually on 1 May beginning next year from my account:
Name of Account …………………………………………
Account No. ……………………………...
Branch Sort Code ………………………...

To: BBC Pensioners' Association, Barclays Bank plc. Crawley Branch. The Gatwick Group. Sort Code: 20-23-97   Account No: 50161101

Signature ………………………………………   Date ……………………

Note to Bank from BBCPA : Please quote BBCPA Membership Number ................. to identify account from which payment is being made.

This cancels or replaces any existing standing order payable to BBCPA.