BEWSA
MEMBERSHIP FORM
ASSOCIATE MEMBERSHIP : Open to people who do not comply with below
FULL MEMBERSHIP
:
Open to Disabled Service and ex-service personnel
ORDINARY MEMBERSHIP
:
Open to Serving and Ex-serving Able bodied personnel
October 2007 2008
Subscription Fees.
The Royal British Legion,
£10.50
.
BEWSA
£2.50.
I enclose £
2.50
for BEWSA and £10.50 for TRBL Total £13.00 or £2.50 BEWSA
Dive Branch BSAC
2007/2008
£
10
.00 per Year
for members with own kit £40.00 for members with BEWSA kit
Plus BSAC Subscription
Total_____________ Please make cheques payable to BEWSA
Many thanks
Title/Rank/Style:
Surname:
Forenames:
Marital Status:
Sex:
Date of Birth:
Address:
Telephone No. Day:
Evening:
Mobile:
Email:
___________________________
I WOULD LIKE MY NEWSLETTER BY
POST
Y/N
EMAIL
Y/N
SERVICE DETAILS
Branch of Service ( R.N./ARMY/R.A.F./R.M.)
Regiment/Corps:
Last Unit/Establishment Served:
Rank/Rate:
Service Number:
Date Enlisted:
Date Discharged:
War Pensioner:
Yes
No
TYPE OF MEMBERSHIP:
FULL/ORDINARY/ASSOCIATE
(PLEASE CIRCLE MEMBERSHIP APPLIED FOR)
SIGNATURE:
.. DATE:
FOR FULL MEMBERSHIP
Nature of Disability: (Tetra
(complete, incomplete)
/Para
(complete, incomplete)
/Amputee/Other
please give FULL details:
Continue overleaf if necessary
Level/Description of Injury: (T?/C?/L?, A/K
B/K)
Date of onset of disability
.
Sports Classification if Known:
Preferred Sports:
FOR FULL/ORDINARY MEMBERSHIP (New Members Only)
FOR NEW MEMBERS PLEASE ENCLOSE A COPY OF YOUR SERVICE DISCHARGE
PAPERS
FOR OFFICIAL USE ONLY
Date Received
Subscription Fee Enclosed: Yes/No
Date Approved/Not Approved by Executive/Branch Meeting
.
Membership Number
. I.D. Card Issued
Yes/No
Date
PLEASE RETURN FORM TO
NICHOLA SIMMONS
53 CHESTNUT AVENUE
BLYTH
NE24 1PH