Dundee U3A Membership Application Form 2021-22

Fees for 2021-22: Individual - £13.00; Member of other U3A - £7.00

New members - before submitting this form please contact the group leader(s) to ensure you are able to join at least one of your preferred groups.

*Required fields

Name*

TitleFirst NameLast Name

Address line 1*

Address line 2

City/Town*

Post Code*

Are you retired from full-time employment (this is a requirement for membership - semi-retired is acceptable)?*

E-mail

Home Phone Number

Mobile Phone Number

Emergency Contact - this is someone we can contact on your behalf in the event of an incident

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number*

If you are a UK taxpayer and agree to us reclaiming tax through the Gift Aid scheme please select 'Yes'*

To keep our costs down our Newsletter will be issued by email. If you would prefer a printed copy please select 'Printed copy'

I agree to the above information being held by Dundee U3A for the purposes of the direct mailing of the Third Age Matters magazine (Your consent is required under Data Protection Regulations)*

Comments

When joining a class for the first time, please contact the leader/facilitator before attending.

When you have completed this form click on the 'Submit Application' button below. You will then be able to pay using PayPal - no PayPal account is needed, you can use a debit or credit card (select the 'Pay by Debit or Credit Card' button at the bottom of the PayPal login screen).

Enquiries to:

Mrs. Sybil Berrecloth

Telephone – 01382 457601

E Mail: du3amemsec@gmail.com

Membership Application 2021-22