BALPA Members Application and Direct Debit details

Personal details

Title
Forenames
Surname
Gender
Birth Date (dd/mm/yyyy)
Nationality

Contact details

Address Line 1
Address Line 2
Address Line 3
Address Line 4
Postcode
Email Address
Mobile Telephone
Next of Kin
Next of kin phone number

Employment details

Company
Are you a contractor?
Employment Status
Trainee School
Rank
Base
Fleet
Staff Number
Company Join Date (dd/mm/yyyy)
Total Pensionable salary


Please note your subscription may be based on this figure. It is important that you keep us advised of any future changes to your salary so as to ensure that your membership remains in good financial standing. BALPA subscriptions are based on your salary on the date of joining and are revised annualy to reflect your salary on the 1st of January each year.

Declarations

I hereby apply for membership of the British Airline Pilots Association.
Please tick if you consent to the processing of the data by BALPA as defined by its register entry under the Data Protection Act.
BALPA Financial Solutions Limited (BFS) is wholly owned by BALPA and was created to provide members and their families with impartial advice. I agree my details can be supplied to BFS so they may contact me with relevant financial planning advice.

Your direct debit details

INSTRUCTIONS to your Bank or Building Society to pay by Direct Debit

BALPA, BALPA House, 5 Heathrow Boulevard, 278 Bath Road, West Drayton, UB7 0DQ
Account Holder Name
Account Number
Bank Sort Code

Please tick to confirm you are the only person required to sign for this account
Checking this box indicates that I am the Bank/Building Society holder and no authority other than my own is required.