Membership Joining – Frinton, Walton, & District u3a

First Name

Prefer to be known as

Surname

Address

Post code

E-Mail address

Telephone

Mobile

I would like to be contacted By emailin printed format

What you are agreeing to

I wish to apply for Membership of Frinton Walton and District u3a (FWDu3a)
I agree to observe the Code of Conduct and Policies of FWDu3a
I agree to bring my Membership card to meetings and groups
I understand that I have the right to vote at AGMs and other necessary occasions
I agree that wherever and whenever possible I will take an active role in the development and functioning of FWDu3a
FWDu3a take your privacy seriously and will only use your personal information to administer your membership or to contact you regarding your membership or u3a activities and events (local and national). Your information will be stored securely and will not be shared with any third party other than where it is legally required. By signing this application I indicate that I understand the above and consent to my personal information being stored for this reason.

Third Age Matters – the Third Age Trust Magazine, published 5 times per year and direct mailed to you. Additional £4. No thank youYes please

Payment £16 membership only£20 membership + magazine

Payment Cheque: made payable to FWDu3aBank transfer 30-99-50 27610060Cash

Enter your signature (name)

Date of signing

Gift Aid Declaration: (if you pay UK Tax, please help us to claim some back at no cost to you) I want FWDu3a to treat my annual subscription as a Gift Aid donationI don't pay taxI don't want to gift aid

You can cancel this Gift Aid Declaration at any time by notifying FWDu3a (Membership)
You must be paying income tax and/or capital gains tax at least equal to the basic rate tax
If in future your circumstances change, and you no longer pay the above tax at the basic rate you must inform FWDu3a
If you pay tax at the higher rate, you can claim further tax relief in your self-assessment tax return

Enter your signature (name)

Date of signing

You can go back and check or change any of your responses using the ' Previous' button below. Once you are happy with all your selections, please click the submit button below.