New Membership Application

Application for new membership

Please read the notes below before completing the form.

One form per member
Mandatory fields are marked with a red star
Your membership is valid until 31^st August. We will remind you when renewal is due. New members who join after 1^st June will have membership until 31^st August next year.
Please make payment by one of the following options:
- By bank transfer/standing order (details below)
- By credit/debit card by phone. Membership Team (after completing this form) will call you in the next few days to take your payment.

Chichester U3A On-line Membership Application

Personal Details

Title * Title

Click to select

Known As *

First Name(s) *

Last Name *

Email Address

These fields are not mandatory, but please provide an email address or telephone number, or both if possible, as these are our preferred means of contacting you.

Phone Number

0xxxx xxxxxx

Mobile Phone Number

0xxxx xxxxxx

Address

House No/Name *

Street/Building

Address Line 3

Address Line 4

Town *

County County

Click to select

Post Code *

Membership Class

An associate member will already be a member of another U3A through which he/she will have paid a capitation fee to our parent body, the Third Age Trust. This fee does not have to be paid twice, therefore there is a discount for associate members. For postage purposes it is useful for Chichester U3A to link joint memberships so if the same address is shared please give details of your joint partner.

Membership class *

Name of primary U3A

You must be a member of another U3A

Membership number in that U3A (if known)

Partner's name
Unless your partner is an existing Member we will need an application form for both parties together with payments

Partner's membership number (if known)

About you

Background, skills and interests

Newsletter options

Our periodical Newsletter will normally be emailed to you. If you would prefer to receive a paper copy by post please select above.

Bulletin options

The weekly Bulletin giving the latest news and changes will normally be emailed to you. It is also published on the Chichester U3A website. If you would prefer not to receive the weekly email please select above.

Payment

The standard membership fee for 2020/21 is £18 per person. This 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 liability insurance cover. Associate members do not have to pay this fee twice, and an Associate membership fee is therefore discounted to £14.00

Standard Payment declaration *

I have made an electronic transfer in the sum of £18.00 to Chichester U3A, Lloyds Bank plc, sort code 30-91-97, account no. 34913960, using my name as reference.

Please call me to take a debit/credit card payment.

Associate Payment declaration *

I have made an electronic transfer in the sum of £14.00 to Chichester U3A, Lloyds Bank plc, sort code 30-91-97, account no. 34913960, using my name as reference.

Please call me to take payment by phone.

Gift Aid If you are a UK taxpayer, then making a gift aid declaration is an easy way to allow Chichester U3A to reclaim the tax you have already paid. Your subscription is worth 20% more to Chichester U3A when you gift aid it. Anyone who pays UK income or capital gains tax can make a gift aid declaration.Your declaration will cover current and all future membership subscriptions to Chichester U3A.You can cancel your gift aid declaration at any time by informing the Membership Team.

Gift Aid Declaration

Yes, I am a UK tax payer and I would like the tax to be reclaimed on any eligible membership subscriptions that I have made to Chichester U3A since 6th April 2000 or will make to that organisation until further notice. I confirm that I pay an amount of UK income or capital gains tax at least equal to the tax which Chichester U3A will reclaim.

Privacy Statement

Your name and address will be held on a database by the Chichester U3A and the Third Age Trust mailing house for the purposes set out below: * To store it securely for membership and administrative purposes. * To communicate with you as a U3A member. * To share with group leaders and event organisers for those groups and events you have an interest in. * To send you general information about the Third Age Trust (the national organisation to which U3As are affiliated). For more details of Chichester U3A’s Privacy Policy, please visit the Chichester U3A website.

Please tick the box below to give Chichester U3A permission to use the information you have supplied as described:

I consent to my data being used for membership purposes as detailed above.

(Of course, if you do not provide Chichester U3A with any personal details it will be hard to share with you the full benefits of membership.)

The Third Age Matters magazine and Sources magazine are produced by the Third Age Trust. They hold the details of U3A members and will not divulge these to other organisations or parties.

I consent to my data being shared with the Third Age Trust for the purpose of distribution of these Magazines.

Remember you can request a change to your data permissions, or a change to your stored details at any time by contacting us:

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