New Membership Form Title MrMrsMissMs First Name. Surname..... Address line 1 Address line 2 Address (City) Postcode..... Home phone... Mobile......... email address..... Membership Subscriptions Arnoldu3a member Full Nov.- £15, Partial- March £9, August- £6 Associate member Full-Nov.- £11, Partial- March £5, August- £2 Individual*Associate If a member of another u3a and paying full fee to them, then please enter the name of the u3a and your membership number Ways to pay CashChequePaypalBank Transfer If paying by cheque please send it to John Gardner, Membership Secretary, 9 Dalbeattie Close, Arnold, NG5 8QX Bank Transfer Information:- Arnold Univ of Third Age fee acct 08-92-99 Acc.no. 67223118 I consent to my data being used for Arnold u3a membership purposes only - YN We sometimes take photos or Videos of our activities. Please indicate if photos/videos of you may be published for promotional purposes - YN I wish to receive the free Third Age Trust magazine - YN Charity Gift Aid Declaration If you pay income or capital gains tax we can claim Gift Aid back from the Government so we would appreciate it if you would complete the below statement. I would like Arnold u3a to reclaim the tax on any donations or membership subscriptions I make to them. I confirm that I am a UK taxpayer and pay tax at least equal to the tax to be reclaimed. —Please choose an option—yesno Δ
