Membership Application Form
Please see the membership information at https://boltonu3a.org.uk/Join-Us/ for terms, conditions and fees. Your application is processed by real volunteer humans, so please expect occasionally to wait a few days before getting a reply. We do our best to be quick but sometimes have to take a break!
Name
*
Prefix
First Name
Last Name
Email address
*
example@example.com
Home Address
*
House number or name
Street Name
City
County
Post Code
Phone Number
-
Area Code
Phone Number
Mobile phone
Please enter a valid phone number.
Format: 00000000000.
Emergency Contact name and number
*
Previous occupation or industry
Vocational / professional skills?
Would you be interested in helping out by becoming a committee member?
Yes
No
If you are a member of another u3a, state which one
Where did you hear about Bolton u3a eg magazine, word of mouth, poster
Do you agree to abide by the terms and conditions of Bolton u3a , as at https://boltonu3a.org.uk/Membership-pack/
*
Yes
Please give consent for us to use your information in accordance with our GDPR statement at https://boltonu3a.org.uk/Membership-pack/
*
Yes, you have my consent
Confirm that you have read the 'Groups Disclaimer' as shown at https://boltonu3a.org.uk/gallery/Bolton%20u3a%20groups%20disclaimer%20sep%2022.pdf and that you understanding that your u3a insurance cover applies only in relation to our organised activities
*
I have read the Groups Disclaimer and agree
Are you happy to be added to the direct mailing list for the Third Age Trust magazines – Third Age Matters and Sources.
*
yes
No
May Bolton u3a use your image for general information for publicity and information, online or in print?
*
Yes
No
Confirm that you have paid your subscription fee of £20 / £16 if a member of another u3a using BACS details: Account name: Bolton U3A Sort code: 30-91-01 Account number: 01623946
*
I have paid by BACS
Submit
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