2018-19 Annual Membership Application Form
Swindon U3A
Registered Charity No. 298853

Please complete all the relevant sections and return the form to,
U3A Office, Gorse Hill Community Centre, Chapel Street, Swindon, SN2 8DA
if you require your membership card to be sent to you, then please enclose a stamped addressed envelope,
otherwise the card will be held at the office for collection

If completing by hand, PLEASE USE BLOCK CAPITALS.   (You can enter two people living at the same address on this form)

Please tick (✔) here if a new member
Office use only
FIRST APPLICANT:
Name:
Known as:
Address:
Address:
Email address:
Contact No:
Please tick (✔) here if a new member
Office use only
SECOND APPLICANT:
Name:
Known as:
Email address:
Contact No:

The membership fee for 2018-19 is £32 per member. If you are a member of another U3A which pays your capitation fee, your membership fee is £28.75. Please CIRCLE your payment method below.

I / We are paying by   CASH   /   CHEQUE   /   ON-LINE BANK TRANSFER

In joining Swindon U3A, I / we give my / our consent for my / our personal details to be stored and used as stated in the Swindon U3A Privacy Policy.

The Swindon U3A bank account details are:   SORT CODE: 40-52-40     ACCOUNT NO:  00022105

Please use your last name follwed by the last six digits of your telephone number as the payment reference.

Reference:
(Your £32 will be worth £40)

Gift Aid allows Swindon U3A to recover tax from HM Revenue and Customs on a subscription. Each applicant for whom we claim Gift Aid must pay enough UK Income or Capital Gains Tax in the financial year to cover the amount we will reclaim. If you and/or the second applicant are a tax payer and wish Swindon U3A to treat this and subsequent payments as Gift Aid donations, please enter the date and tick the appropirate box below.

FIRST APPLICANT:   Date:
SECOND APPLICANT:   Date:

By agreeing that Swindon U3A can claim Gift Aid, you agree to your names and address being passed to HMRC.

Note: You may cancel this at any time and MUST cancel, if you cease to be a tax payer, by informing the office on 01793 614629 or the treasurer@swindonu3a.org.uk.

Please indicate your choices by inserting a tick (✔) in the boxes for any of the following,
I would like to receive Third Age Matters from the Third Age Trust:
By agreeing to receive Third Age Matters, I / we agree to my / our names and address being passed to the distributor.
I would like to receive the Newsletter by email:
I would like to help as a volunteer in the office:
Have you expertise to share?