Thorn and EMI Group Pensioners Association
Affiliated to the Occupational Pensioners' Alliance, OPA

MEMBERSHIP APPLICATION FORM

We cannot yet do on line applications so we would be obliged if you could print this form.

Membership is open to all Thorn and EMI Group pensioners and deferred pensioners.
Annual membership subscription: £5.00,
free to all pensioners receiving a pension of £1000.00 or less per year.

To: Fay Kidd - TEPA Treasurer,
3 St. Helens Crescent,
Sandhurst,
Berks GU47 9AX

(PLEASE PRINT NAME & ADDRESS etc..)
Name:_______________________________Spouse's name:___________________________
Address:_____________________________________________________________________
___________________________________________________________________________
Post Code:____________________Tel No__________________________

Is Your Fund:
Thorn____________________
EMI Group________________		 Is Your Pension:
Being Paid________________
Deferred__________________
A Dependent's______________
Data Protection Act 1984
We hereby give permission for details contained in this Application Form to be used
in connection with the objectives of the Association and in conformance with the
principles of the Act.
Cheques should be made payable to Thorn & EMI Group Pensioners' Association. A receipt will be provided on request.
An SAE will be welcomed. Thank you.
(For office use)
Membership No:T/E......................
Joining Date:.................................
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