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Membership is open to anyone, aged 18 and over, who  wishes to support the aims of the British Association. Annual subscriptions are €20 single membership and €32 for a couple. The student subscription rate is €10 on presentation of justification. The subscription itself covers administrative costs, postage, paper etc, and we invite you to make a donation to support our welfare work if you wish. Please print  and complete this form and send together with your cheque to the branch of your choice (see below).

                    British Association of the Alpes Maritimes

                             Annual Membership 2014

                      ............................BRANCH  (1)

1. First Name : ___________________ Surname:_________________________

Mobile telephone ____________________  Date of Birth ___________________

2. First Name  :____________________ Surname:________________________

Mobile telephone ____________________  Date of Birth ___________________

e-mail (s) _________________________________________________________

Address:   _________________________________________________________

                 _________________________________________________________

Telephone :__________________ 

Are you willing to receive correspondence by e-mail only?                       Yes / No

Are you a permanent resident of the Alpes-Maritimes?                            Yes / No

if "no" please give details of alternative address and telephone number :

 

 ___________________________________________________________________

 

Subscription    €.............. (€20 per single person,  €32 per couple, 10€ for students(2))

 

Donation         €..............

 

Total               €_______

 

Optional information   - would you like to;


1.   Attend social functions                                                                               (Yes / No)
2.   Assist with social functions                                                                        (Yes / No)
3.   Visit people in hospital, in their home or retirement home                        (Yes / No)
4.   Offer to drive someone                                                                              (Yes / No)
5.   Assist someone with shopping                                                                  (Yes / No)
6.   Offer any other assistance
which could contribute to our welfare programme (for example legal, computer knowledge, financial, interpreter, organising events.............)

Please state on the line below :-

____________________________________________________________________

 

 

Signature:___________________________ Date:___________

Please make cheques payable to the British Association and send to the branch of your choice, as follows :-

Menton Branch  Birgitt Nordrbink, Villa Nirvana, 65C Avenue de Sospel 06500 Menton

(1) Please specify NICE, CANNES, or MENTON

(2) Please supply justification of student status

 
 
 

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