Verulam

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Verulam U3A Membership Application

Please select the type of membership you require
AssociateFull Member of Another U3A£ 10.00
IndividualFull Member£ 15.00
Joint Members1 of 2 people at same address (HMRC family)£ 14.00

Membership paid today continues until 1st August 2020

Then enter the following information. Fields in bold are mandatory.

About Yourself
Title      Forename      Surname       male female
E-mail      Mobile      Known as
Emergency contact
Upload photo (optional)      jpg, png, gif. Recommended max size 2MB
Own U3A (where you are a full member)
Tick if you pay UK tax and wish U3A to claim Gift Aid on your subscription (if applicable)
About Your Partner
Title      Forename      Surname       male female
E-mail      Mobile      Known as
Emergency contact
Upload photo (optional)      jpg, png, gif. Recommended max size 2MB
Your Address
No/Name      Street
Additional lines
Town      County      Postcode
Telephone
Payment

Amount to pay:  

Press the button below to proceed to PayPal to make payment
You may pay by credit or debit card or use a PayPal account
After payment, you should receive an e-mail from PayPal as a receipt and an e-mail from Verulam U3A to confirm membership
The data you provide will be held electronically by Verulam U3A to facilitate your membership.
If you have any concerns, please contact the Membership Secretary.
Problems or Enquiries?: membershipsecretary@verulamu3a.org