Membership Application Form

Newmarket U3A

Application for Membership or Renewal
Your Details
Title * First Name* Last Name *
Address

Street Address

Street Address line 2

VillageTown / City

Post Code
Home Telephone Number

Area CodePhone Number
Mobile Number
E-mail*
*To reduce costs email is our preferred method of communication where possible.
Date

DayMonthYear
In submitting this form I apply for membership of Newmarket U3A and confirm that I will abide by the terms and conditions of membership as stated below. I confirm that I have completed the form myself or have been assisted to do so.
Membership Fees
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Full Annual Membership(Membership year commences 1st August). Our membership fee is *£15.00 per annum unless you are a full member of another U3A, when it reduces to £11.00. (This fee* includes a £4.00 membership fee paid to our national organisation, The Third Age Trust, which provides a wide range of services and benefits, including Public Liability insurance cover.)
£15.00



Reduced Fee MembershipThis fee only applies if you have paid full membership fees to another U3A, when it reduces to £11.00.
£11.00



U3A Matters MagazineTick if required U3A Matters national nagazine (Non-refundable fee £3.80) and add fee to costs column. I consent to my data being shared with the company who oversees the distribution of the Trust Magazines
£3.80



Total

£0.00
Your completed form will be sent electronically to the Membership Secretary.

Please send your cheque if applicable to the Treasurer: Mrs Di Angus-Smith, U3A Treasurer, 17 Paget Place, Newmarket CB8 7DR
Membership fees are being paid by (please tick one):*

Bank transfer to Sort Code 30-95-96 Account no. 01368345 Newmarket U3A Events. Please add your Reference (ie your surname)Cheque payable to Newmarket U3A
If you would like to Gift Aid your membership fee, please complete the Gift Aid Form which can be found on page 2 of this Form.
TERMS AND CONDITIONS OF MEMBERSHIP
All members must:
- Abide by the Principles of the U3A movement.
- Always act in the best interests of the U3A and never do anything to bring the U3A into disrepute
- Abide by the terms and conditions of the Newmarket U3A constitution.
- Treat fellow members with respect and courtesy at all times.
- Comply with and support the decisions of the elected Executive Committee.
- Advise the Membership Secretary of any change in your personal details.
PRIVACY STATEMENT
Newmarket U3A processes member information so that we can keep you informed about events, groups and activities as part of your membership. Newmarket U3A’s lawful basis for collecting this information is a contract. In processing your information Newmarket U3A will:
- Store it securely on a computer/paper record. Use it to communicate with you as a U3A member.
- Share your information with group co-ordinators for those groups that you are a member of.
- Send your general information to the Third Age Trust (which is the national office to which all U3As are affiliated) if you have opted to receive TAM.
Full Privacy Policy is available on Newmarket U3A website.
Group Activities - Groups you are interested in:
Where did you hear about us?

Photography - Please tick box to give your consent for your photograph to be taken at U3A events and used for Newmarket U3A publicity purposes. You may withdraw consent at any time by contacting the Membership Secretary. Note: If you do not wish to be in photos please step out of shot.*

Yes I agreeNo I do not agreeOther
Disabilities and Limitations: When taking part in any Newmarket U3A activity, trip or event, it is important that whoever the group co-ordinator is or whoever is leading the activity is made aware of any disability/limitation that you have that may affect your ability to fully participate.

Insurance: Please note that anyone participating in U3A activities does so at their own risk and is not covered by personal accident insurance. Newmarket U3A carries Public Liability insurance cover only.
Gift Aid - Gift Aid legislation allows us to reclaim 25p of tax on every £1 that you provide in your fee and any donation you may make. If you are happy for us to do this please complete the declaration below. If you currently hold a Deed of Covenant, please complete this declaration as it is easier for us to claim Gift Aid.*
GIFT AID DECLARATION - NEWMARKET U3A - Registered Charity No.

TITLE FIRST NAME LAST NAME DATE

I wish Newmarket U3A to further benefit from Gift Aid legislation and confirm I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current year than the amount of Gift Aid claimed on my fee, it is my responsibility to pay the difference. I understand that other taxes such as VAT and Council Tax do not qualify. This declaration applies to all eligible membership fees I have made during the last 4-year period and until further notice.

Please remember to notify us if you wish to cancel this declaration, change your name or home address, or 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.
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