MNA Membership Application Form

Please enter required information as shown on the Form

Discharge Book and Employment Info is required for Full Membership

When you have completed this Application form select the SUBMIT button.

Once your subscription has been received, you will get a confirmation from the

National Membership Secretary

Full Membership is available to those who have served at sea on a merchant or fishing vessel. Full Members have full voting rights and are eligible to be elected to the National Council.

Associate Membership is available to anyone who would like to support the Association but will not be eligible to vote or stand for election.

Type of Membership Required *

Name *

Title Forename Surname

Full Address - (include PostCode & Country etc) *

Contact Phone Number(s) *

Email *

example@example.com

Discharge Book Number - Required for Full Membership

Please provide names of first and last ship (joined/left with dates) and shipping company. If no Discharge Book, please provide evidence of your current/past employment

Next of Kin (optional)

Name Relationship Contact Number

Are you an Armed Forces Veteran, have served in the RFA or served on a vessel in support of HM Armed Forces. The MNA may need to verify this with documentary evidence. *

Yes No

I agree to The MNA using my email for membership communications including Newsletters etc for the duration of my membership (we do not share your email with 3rd parties) *

Yes No

The MNA’s Data Protection Policy can be found on the MNA website and is aligned with the principles detailed in the General Data Protection Regulations/Data Protection Bill 2019.

GIFT AID DECLARATION - MNA Charity No. 1135661

If you are a UK taxpayer you can boost your donation by 25p for every £1 you donate. Gift Aid is reclaimed by The Merchant Navy Association from any tax you pay in the current year. Please select YES or NO in the box below to confirm that you wish to (or not wish to) Gift Aid any donations you make now and in the future.

See also separate page 'DONATIONS' on MNA website.

I wish to Gift Aid

Signature *

Clear

Date *

Date

Membership Fees

UK Applicants

Annual Membership Fee £12
One-Off Registration Fee £7

TOTAL £19

Overseas Applicants

Annual Membership Fee £18
One-Off Registration Fee £7

TOTAL £25

When selecting payment method below, please read drop down NOTE that appears

Donation (optional) Thank You £

Total Amount Being Paid £ Thank You (£19 or £25 plus any optional Donation) *

Select one box to pay *

Debit/Credit Card Cheque by Post BACS/Online PayPal

Thank you for choosing to pay by Debit/Credit Card.

The National Membership Secretary will accept payment by this method over the phone:
Mobile: 07738 425875

When completed, don't forget to submit this Application Form by clicking on the SUBMIT button at the bottom of this Form.

Thank You

Thank you for choosing to pay by Cheque.

Please make the cheque out for the required amount, payable to THE MERCHANT NAVY ASSOCIATION and forward to the:

National Membership Secretary,
3 The Maples, Fleet Hargate, Spalding, Lincs. PE12 8NT

When completed, don't forget to submit this Application Form by clicking on the SUBMIT button at the bottom of this Form.

Once your subscription has been received, you will get a confirmation from the National Membership Secretary.

Thank you

Thank you for choosing to pay by BACS

...... online direct from your account. Please pay £19 (New UK Membership) or £25 (New Overseas Membership) to National Merchant Navy Association at National Westminster Bank, Sort Code 51-81-34, Account number 28707680 - quoting your name as reference.
When completed, don't forget to submit this Application Form by clicking on the SUBMIT button at the bottom of this Form.

Once your subscription has been received, you will get a confirmation from the National Membership Secretary.

Thank you.

Thank you for choosing to pay by PayPal.

When completed, don't forget to submit this Application Form by clicking on the SUBMIT button at the bottom of this Form.

On the Thank You page, click on the relevant PayPal link, which will take you to the payment page on the MNA website.

** IMPORTANT - PLEASE NOTE **

DONATIONS NEED TO BE ENTERED SEPARATELY ON THE PAYPAL PAGE

Once your subscription has been received, you will get a confirmation from the National Membership Secretary.

Thank you.

Full details on Membership can be obtained from the MNA website
and the National Membership Secretary:
3 The Maples, Fleet Hargate, Spalding, Lincs. PE12 8NT
Mobile:07738 425875 EMail: membership@mna.org.uk

MNA Boat Club

If you are interested in small boating visit the MNA Boat Club page.

Please indicate if you are interested below.

There is no membership fee to join.

I would like to receive more information about the MNA Boat Club *

Yes No