BA CLUBS MEMBERSHIP FORM

1
BA CLUBS MEMBERSHIP FORM BA STAFF
APPLICANT DETAILS

Mr
Mrs
Miss
Other
(relative of another member specify)
Surname
Address
First Name(s)
Telephone Home/Mobile
Email
Date of Birth
Staff No
Male
Female
CLUB MEMBERSHIP
Heston (Imperial College)
South Wales
Direct Debit Payment
Newcastle
BAMC
BAAE
BAIE
Annual
Regions
Retired
Monthly
Retired Spouse
Gatwick
Payroll
Scotland
ADDITIONAL SUBSCRIPTIONS
Section (specify)
Section (specify)
Direct Debit Payment

Annual
Heston Gym
Note A separate direct debit is required for
each subscription
Monthly
Lottery
BA ACTIVE GYM SUBSCRIPTION
Waterside
Cargo
The Link
Direct Debit Payment
Annual
Monthly
AUTHORISATION
I authorise British Airways to deduct from my pay
the Club subscription at the current rate agreed
by the Trustees. I hereby declare that the
information I have given is to be true and that I
agree to be bound by the Rules of the Club.
Personal data provided by you will be held on
computer for the purpose of administration and
will be used in accordance with the provisions of
the Data Protection Act 1984. Please tick here
if you do not wish to receive direct marketing
from the Club
Signature
Date
OFFICE USE ONLY
ID No
DD
DD
CB No
DD
Initials