EDF Energy (Barnwood) Sports & Social Club Membership Application Form
Ordinary Members - £1.25 per month - Ordinary membership is available to any employee of EDF Energy. The company contributes £1 .25p per month per member. Subscriptions can only be paid monthly by salary deduction, so please complete the salary mandate form overleaf.
Barnwood Site Members - £30 per year - Any person employed other than on a temporary basis on the Barnwood Site, and who is not an employee of theElectricity Supply Industry is eligible for Barnwood Site Membership.
Family Associate Member - £4 or £13 per year* - Family Associate Membership is available to the families of members of the Club, who wish to participate in Section activities. For a Husband, Wife, Partner or Child under 18 the fee is £4 per year. For all other family members the fee is £13 per year.
Associate Member - £30 per year* - Associate Membership is available to those whom the Committee consider will further the aims and objectives of the Club, or who can show some continuing association with the EDF Energy Office.
*If subscriptions are to be paid by Standing Order, please complete the form overleaf. If paying by cash or cheque, please send payment with your application. To be valid, Associate Membership cards must have a photograph affixed. This is to assist the security staff on site.
Cheques should be made payable to EDF Energy (Barnwood) S & SC.
Return this application form to the EDF Energy (Barnwood) S&SC Office, Barnett Way, BARNWOOD, Gloucester, GL4 3RS.
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Section 1 - All members to complete.
Please enrol me as a member of the Sports & Social club.
TITLE INITIALS SURNAME
FIRST NAME DATE OF BIRTH
HOME ADDRESS
POSTCODE
TELEPHONE HOME E-MAIL ADDRESS
Section 2 - Ordinary Members & Barnwood Site members only to complete
SITE LOCATIONNETS EXT
Section 3 - Barnwood Site members only
EMPLOYER
Section 4 - Associate only to complete
PROPOSEDBY NAME MEM NO
SIGNED
Section 5 - Please enrol the following as family members of the Club
FULL NAME (Including First Name) / RELATION / DATE OF BIRTH / FEE */1 / £
/2 / £
/3 / £
* Fee is £4 for Husband/Wife/Partner/Children under 18. Fee is £13 for Children over 1 8/Son-in-Law/Daughter-in-Law/Father/Mother. / TOTAL / £
DATAPROTECTIONACT
For membership administration and mailing list purposes the details given on this form will be stored on a computer.
Please tick one box: I agree: [ ]I do not agree: [ ]
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EDF Energy (Barnwood) Sports & Social Club - SALARY DEDUCTION MANDATE
To:Salaries Section, PeelPark
I have joined the EDF Energy (Barnwood) Sports & Social Club: please deduct the amount shown below from my salary. I also agree that if, in the future, the membership subscription is increased in accordance with a valid resolution duly passed at a General Meeting of the Club, the revised amount can be deducted. £1.25 per month
Name: (Capitals please)
Payroll No.
Signature:Date:
To Bank/Building Soc
Address
NAT WEST, GLOUCESTER BRANCH SORT CODE 60-09-02
EDF ENERGY (BARNWOOD) S&SC SUBSCRIPTION ACCOUNT ACC. NO. 46707239
the sum of £ (Amount in figures) (Amount in words)
commencing on (Date of First Payment) and thereafter every YEAR,
until you receive further notice from me/us in writing, quoting the reference ______and debit my/our account accordingly.
Please cancel any previous Standing Order or Direct Debit in favour of the beneficiary named above under the reference.
Account to be debited / Account NoSignatures: …………………………………………………………………………………………………….
Date: ……………………………………………