Interest Groups Contacts

Romsey & District u3a

MEMBERSHIP APPLICATION/RENEWAL 1APRIL 2022 - 31 MARCH 2023

Please return to: Mrs M Fowler, 33 Winchester Road, Romsey SO51 8AB or email: marionfowler@btnternet.com

YOUR DETAILS Are you a current member? Yes / No

Title First Name

Address Surname Member No. if renewing

Post Code Home Telephone

Email *

EMERGENCY CONTACT Name Mobile / Telephone Mobile

GIFT AID Please sign up if you can - boost your donaton by 25p in every £1 and help us to cover our costs. I would like Romsey & District u3a to reclaim Gif Aid on my Membership contributons for this year and any I make in the future. I confrm that I am a UK tax payer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gif Aid claimed on all my donatons in that tax year, it is my responsibility to pay the diference.

Please tck ONE box: I would like to partcipate I am not eligible or do not wish to partcipate * To reduce costs, the commitee will communicate with you via email where possible.

MEMBERSHIP FEE

Romsey & District u3a One member £15.00 OR Other u3a One member £11.00 ** See below

My Membership fee will be paid by (please tck ONE): □ Standing Order - if already in place □ Bank Transfer to: Barclays Bank; University of the Third Age Romsey & District U3A; Sort Code 2 0-97-01; □ Account No. 20473111; Reference - your 4-digit Member No. OR your Surname, then initals □ Cheque made payable to ‘Romsey & District U3A’

** If you are already a member of another u3a and pay your Third Age Trust Capitaton Fee through them, your Romsey & District u3a fee will be £11.00. Please complete the following declaraton and sign it.

I have paid or will be paying my Third Age Trust Capitaton Fee to:

Branch ……………………………………………. Member No. ………………… Signature ………………………………………………………..

*** PLEASE TURN OVER ***

• Abide by the Principles of the u3a movement.

• Always act in the best interests of the u3a and never bring the u3a into disrepute. • Abide by the terms and conditons of the consttuton. • Treat fellow members with respect and courtesy at all tmes. • Comply with and support the decisions of the elected commitee. • Advise the Membership Secretary of any change in your personal details.

I apply for membership of Romsey & District u3a and confrm that I will abide by the terms of membership as stated

Signed: Date:

STANDING ORDER If you would like to pay by Standing Order in future years, please tck the box below.

Please send me a Standing Order form □

NEWSLETTER Your quarterly Newsleters will be sent to the email address you have provided. If you need a

printed copy please make sure you have told us.

THIRD AGE TRUST MAGAZINES (TAM) If you wish to receive these please tck. □

PRIVACY STATEMENT A copy of our Privacy Statement can be found on our website, or on request. The informaton you have supplied will be used in the following ways: • To store it securely for membership purposes. • To communicate with you as a u3a member. • To share with group leaders for those groups that you are a member of. • To send you general informaton about the Third Age Trust (the natonal organisaton to which u3as are afliated).

ACCIDENT DISCLAIMER Members are advised that Romsey & District u3a cannot be held responsible for any personal accident, or any loss, damage or thef of members’ personal property at any of the meetng halls used for general and group meetngs, or visits organised by recognised groups of this u3a. However members are covered against proven liability to Third Partes.

Please advise any change of circumstances or data as soon as possible by contactng us at:

Email: marionfowler@btnternet.com

Ofce use

Bank Transfer: Cheque: Cash: Date: