U3A in Bath     MEMBERSHIP APPLICATION FORM
To join us, please bring this form to our next monthly lecture morning between 9:45 and 10:20am or alternatively, mail this form to the Membership Officer, U3A in Bath, PO Box 4040, Bath BA1 0EJ with a cheque for the appropriate amount made out to U3A in Bath.
If you are two people in the same household, please use a single application form. This avoids two newsletters going to the same address and two separate renewal letters being sent to you each year.

Annual fees:
To receive your monthly newsletter by email:  15 for one member; 30 for two.
To receive your monthly newsletter by post:    30 for one member; 45 for two.


First Person Second Person
Title
First / Preferred Name
Surname
Mobile No
Address 1 Enter ONE postal address only
Address 2
Town/City
Post Code
E-mail Address
Home Phone
Newsletter
 Please click here if you prefer to receive your newsletter by post rather than email (there is an additional cost of 15 for this service)
Welcome
 We like to welcome new members in the newsletter, please click here if you are happy for us to mention your name
Do you have any skills and interests which may be useful to U3A?
First person
Second person
How did you find out about the U3A? (please click)
 Word of Mouth    Poster in library   Poster in shop   Advert in local press 
 Internet search   U3A website   U3A Open Day
Other (specify)

Gift Aid Declaration
I want to Gift Aid all subscriptions I make to the U3A in Bath in the future or have made in the past four years.
I am a UK taxpayer and understand that if I pay less tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.
I will notify the U3A in Bath if:
  • I want to cancel this declaration;
  • I change my name or home address;
  • I no longer pay sufficient tax on my income and/or capital gains.
Signed

Date
Click one box only I am the     1st   person   2nd    person.