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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£5.00
Joint Members1 of 2 people at same address (HMRC family)£5.00
New Associate MemberAssoc. joining between 1-7-22 and 31-7-23£10.00
New MemberJoining between July 1 2022 and July 31 2023£5.00

Membership paid today continues until 1st August 2024

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

About Yourself
Title      Forename      Surname       male female
E-mail      Verify E-mail
Mobile      Known as
Emergency contact
Upload photo (optional)      jpg, png, gif. Recommended max size 2MB
Provide a square format image (aspect ratio 1:1) as other formats will not suit the membership card layout
Own U3A (where you are a full member)
About Your Partner
Title      Forename      Surname       male female
E-mail      Verify 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
Gift Aid

Your subscription can make each £1 of your subscription worth 25p more and at no cost to yourself. To qualify for Gift Aid you must pay income tax or capital gains tax at least equal to the amount that Verulam U3A reclaims on your subscription and donations in a tax year.

I am a UK tax payer and wish to Gift Aid this and all future subscriptions and donations that I make to Verulam U3A, unless I notify you otherwise. I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.
I do not wish to Gift Aid my subscriptions and donations.

Please notify us if you:

  • want to cancel this declaration
  • change your name or home address
  • 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.

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?: memsec@verulamu3a.org