Membership Renew by Bank

Title

Your name

Your email address

Mobile Number

Home Phone

Address

Post Code

Emergency Contact & Number

Would you like to assist us in running the U3A? If so, in what capacity might you be interested?

Which interest groups might you be interested in joining?

PRIVACY STATEMENT AND GENERAL DATA PROTECTION REGULATIONS CONSENT
In signing below you give us permission to use the information you have supplied in the following ways:
• To store it securely for membership purposes.
• To communicate with you as a U3A member.
• To share with group leaders for those groups of which you are a member.
• To send you general information about the Third Age Trust (the national organisation to which U3As are affiliated). Your details will never be supplied to an outside agency. You can request that your data should not be used for any of these purposes by contacting the Membership Secretary

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I wish to have a copy of Third Age Matters, the national magazine of the Third Age Trust posted to me periodically and consent to share my data with the company that distributes it.NoYes

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TERMS AND CONDITIONS OF MEMBERSHIP
All members must:
• Abide by the Aims and Guiding Principles of the U3A movement.
• Always act in the best interests of the U3A and never do anything to bring It into disrepute.
• Abide by the terms and conditions of the constitution.
• Treat fellow members with respect and courtesy at all times.
• Comply with and support decisions of the elected committee.
• Advise the committee of any change in your personal details.
I apply for membership of Aylesbury Vale U3A and confirm that I will comply with the above terms and conditions.

I consent to my data being used for membership purposes as detailed above. (The full privacy statement is on the website) .
Signature (please print your name to accept)

This is REQUIRED

Date

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GIFT AID DECLARATION
If you are a taxpayer and would like to pay your annual subscription under the Government Gift Aid Scheme, please sign and date the declaration below. This will allow us to reclaim from HRMC 25% of your subscription. You must pay an amount of Income Tax and/or Capital Gains Tax at least equal to the tax that can be reclaimed on your donations that tax year.
Note: if you pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all donations this tax year, it is your responsibility to repay any difference to HRMC.
I declare that I wish Aylesbury Vale U3A, Charity No 1035640 to treat my subscription this year as a Gift Aid donation.

Signature (You may print your name to agree)

Date

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