Join the West Midlands Benevolent Fund

Application to Join the West Midlands Police Benevolent Fund.

Please fill in the form below. All Fields are required.

Personal Number:

Date of Birth:

Force:

Date of Joining the Force:

Name:

Male / Female:

Address:

Postcode:

Telephone:

Email:

Nominee(s):

In the event of death as a serving member a grant of £2,500 will be paid to a named recipient. You may nominate more than one beneficiary please indicate proportion you wish them to receive. For example two named people 50%-50%.

Name

Proportion (%)

%

%

%

%

Full name of advising adult and/or relationship
if beneficiary is under 18 years of age:

Authority for deductions and nominations of beneficiaries
WMP Benevolent Fund.

I hereby authorise the Police Authority, until further notice, to make deductions from my pay at the appropriate rate on behalf of the WMP Benevolent Fund and nominate the under-mentioned person or persons to receive the benefits payable on my death under the Scheme and in the case of a nominee under the age of eighteen years. I hereunder nominate a responsible adult capable of advising such nominee in the best use of such benefits.

Yes I agree