Online New Membership form

Membership Fees
Individual Membership - £17
Individual Membership + Third Age Magazine - £21.50
Individual Membership after 1st November until 30th April - £10
Individual Membership after 1st November until 30th April late Membership - £10
Individual Associate Membership for £10 (Please quote your U3a membership number and the branch you belong to.)

BACS payment information:
Hastings and Rother U3a
Lloyds Bank
Sort Code: 30-90-89
Account No: 55086960

TiTle

Name

First

Last

Known As

Address 1

Address 2

Town

County

Post Code

Home Phone No

Mobile No:

Shares Address with (Name & Membership No)

Email Address

Do you wish to receive the Third Age Magazine? There is an extra charge of £4.50

Yes
No

If you do not have an email address, do you want to receive a printed copy of the Hastings & Rother U3a Newsletter

Yes
No

Please choose the membership type you are submitting?

Individual Membership - £17
Individual Membership with Third Age Magazine - £21.50
Individual Membership (if after 1st November - £10
Associate Membership (If you belong to another branch) - £10

How are you paying?

BACS
Cheque

Date of bank transfer (PLEASE NOTE THAT WE CAN NOT PROCESS YOUR MEMBERSHIP UNTIL PAYMENT HAS BEEN RECEIVED)

Did you pay by card at a monthly meeting?

Yes
No
Not Applicable

The date you paid at monthly meeting

Do you wish to Gift Aid your subscription? Please Read the section on Gift Aid in the Terms & Conditions

Yes
No

Should you become ill whilst you are attending a U3a event or group. Please can you type the name and contact number of the person you wish us to call.

We would like to know what your occupation was before you retired? This will help us to identify any skills you may have, which may be useful to the branch, If you are willing to volunteer

Our U3a is run by its members. We would welcome your participation. Can you offer help in any of the listed categories?

PLEASE NOTE: You must submit an application form to complete your application for membership.

I understand

I apply for membership and agree to the terms & conditions

Yes

Confirm your membership by typing your name.

of Mobile you

Date

Online New Membership form

Please read the Terms & Conditions before completing this form