On-Line Membership Form

For a Printable Membership Form click here

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Membership Form Submitted

Dear Member, Thank you for completing the Online Membership renewal form, I will deal with it as soon as possible. When I have confirmed the payment is in the bank I will renew your membership. You will then be able to pick up your new Membership card at the next month’s General Meeting. Please come and see me at the Membership table to do so. Membership Secretary and Treasurer Terry Francis

On-Line Membership Form

PERSON #1

Surname

Forename

Title

Membership No

If you are a new member, just type New Member in this box

Address

Postcode

Mobile

Telephone

PERSON #2

Surname #2

Forename #2

Title #2

Membership No #2

If you are a new member, just type New Member in this box

Email #2

Mobile #2

West Wolds u3a want our meetings to be as accessible as possible. If you need assistance to attend General Meetings or Interest Groups, please tick here and we will contact you to discuss how we can help.

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Associate Membership

If you pay full membership subscription to another u3a, you can join West Wolds u3a at a reduced fee.

Name of other u3a

Privacy statement
We will use the information you have supplied in the following ways:-

To store it securely for membership purposes.
To share with group leaders for those groups that
you are a member of.
To send you general information about the Third
Age Trust.

To communicate with you as a u3a member.
To share with organisers of u3a visits and events that you are taking part in.
To share with the company who oversee distribution of
the Trust magazines.

Person #1 I consent to my data being used for the above purposes

Person #1 I consent to any photos including my image being used by the West Wolds u3a for advertising, Website and social media,

Date (DD/MM/YYYY)

Person #2 I consent to my data being used for the above purposes

Person #2 I consent to any photos including my image being used by the West Wolds u3a for advertising, Website and social media,

Date (DD/MM/YYYY)

Publications

As a member of the u3a, you are entitled to receive copies of the Third Age Trust’s publications, which will be posted to your home address. Third Age Matters is published 5 times a year with news from the Third Age Trust and from other u3as and their members around the country.

I wish to opt in to receive the TAM magazine

West Wolds u3a publishes a Monthly online Newsletter on our website at westwoldsu3a.org. with information about our own organisation and activities. The link to this will be communicated by email.

Subscription rates

West Wolds u3a’s membership year runs from 1st September to 31st August.
New members joining before 31st May are required to pay the full subscription fee.
New members joining during June, July & August will receive membership until 31st August of the following year.

Full membership
Joint membership (for couples living at the same address)
Associate membership (if you pay a full membership subscription to another u3a)

£18.00
£34.00
£5.00

Door Entry at Monthly General Meetings

There is an entry fee of £1.00 to attend our monthly General Meetings. This is a contribution towards the costs of running these meetings, where members can find out about our Interest Groups, sign up for visits, one-off events and walks, listen to a range of Speakers, and enjoy refreshments while chatting to other members.

Payment Details

Choose one option I will be paying via Online payment (BACS) to Lloyds Bank;a/c The West Wolds University of the Third Age (Sort code 30-96-09, account No 71220968) I will pay by cheque (payable to West Wolds u3a) for Full, Joint or Associate membership as above I will pay with cash or using contactless card at a General Meeting

For renewals, please quote your Membership Number in BACS payment (contact Terry Francis 07840 975547 or via email membership@westwoldsu3a.org for this number if you have mislaid it.)

Signed

Date (DD/MM/YYYY)

Charity Gift Aid Declaration

West Wolds u3a is a Registered Charity (No.1149555). If you are a UK tax payer, we can reclaim 25% of your membership subscription from HMRC. Please sign below to give us permission to reclaim Gift Aid on your subscription.

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations, it is my responsibility to pay any difference.

Person #1 I give permission to claim Gift Aid

Person #2 I give permission to claim Gift Aid

Please notify the charity if you: • want to cancel this declaration • change your name or home address no longer pay sufficient tax on your income and/or capital gains. If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

How to notify us of any changes

If you want to notify us of any changes to your details, or to withdraw permission for us to store and use your data in the ways described overleaf, please contact the Membership Secretary: Mr. Terry Francis
Email: membership@westwoldsu3a.org
Or by Postal address: 1 James Court, Market Rasen, Lincs. LN8 3DU