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Page 1: in retirement - Unite the Union · Annual Six monthly Name of Bank/Building Society: Name(s) of account holder: / Instruction to your Bank or Building Society. Please pay Unite the

in retirement

Join our clubApplication form

Page 2: in retirement - Unite the Union · Annual Six monthly Name of Bank/Building Society: Name(s) of account holder: / Instruction to your Bank or Building Society. Please pay Unite the

for only 55p a weekSimply fill in the form and send it back to us at: Unite Administration

Department, 3 Axis Court, Mallard Way, Swansea Vale, Swansea SA7 0AJ

or go online to www.uniteinretirement.org

Name

Address

Post code

Date of birth

Gender

Home

Mobile

Email

Title

Political CampaigningUnite fights for our members’ interests through political and industrial campaigning on issues affecting you – from pay, pensions, and broader workplace rights to housing, equality issues and our NHS.

If you would like to be part of this, please opt in to our political fund for just 10p per week.

Those who choose not to opt-in will not be disadvantaged in any way compared with members who do opt-in, except in relation to control of the political fund.

I support Unite in campaigning on our policies and members’ priorities in the Labour Party and I would like to be a Labour Party Affiliate Supporter* (this is free for Political Fund payers). I authorise Unite to share my personal data with the Labour Party for this purpose.

Tick if you agree * I agree to the terms listed online at support.labour.org.uk

Page 3: in retirement - Unite the Union · Annual Six monthly Name of Bank/Building Society: Name(s) of account holder: / Instruction to your Bank or Building Society. Please pay Unite the

direct debit detailsInstructions to your Bank or Building Society to pay by Direct Debit

Signature

Date

Originator’s ID Number: 9 7 1 4 6 7

Sort code

Account number:

Annual Six monthly

Name of Bank/Building Society:

Name(s) of account holder:

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Instruction to your Bank or Building Society. Please pay Unite the Union Direct Debit monthly from

the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee.

I understand that this instruction may remain with Unite the Union and, if so, details will be passed

electronically to my Bank Building Society.

DIRECT DEBIT GUARANTEE This Guarantee is offered by all Banks and Building Societies that accept instructions to pay

Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit Unite the Union will notify you

ten working days in advance of your account being debited or as otherwise agreed. If you request Unite the Union to collect

a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the

payment of your Direct Debit, by Unite the Union or your Bank or Building Society, you are entitled to a full and immediate

refund of the amount paid from your Bank or Building Society. If you receive a refund you are not entitled to, you must pay

it back when Unite the union asks you to. You can cancel a Direct Debit at any time by simply contacting your Bank or

Building Society. Written confirmation may be required. Please also notify Unite the Union.

//

Member number: Workplace code:

Employer code: Branch number:

Job code: Recruitment code:

FOR OFFICE USE ONLY

Page 4: in retirement - Unite the Union · Annual Six monthly Name of Bank/Building Society: Name(s) of account holder: / Instruction to your Bank or Building Society. Please pay Unite the

Contacting you

We will contact you regarding items specific to being a member of Unite, including activities, campaigns and benefits.

You can change how we communicate with you at any time using the MyUnite website: www.unitetheunion.org/login/ or by contacting your Regional Office.

Privacy Notice For details as to how Unite will process your data please see Unite the Union’s up to date privacy notice that can be viewed at: www.unitetheunion.org/legal-information/privacypolicy or contact your Regional Office.

0219

- 86

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