Join Form 2021 | North London University of the Third Age

Title

First Name

Surname

Year of birth

Address Line 1

Address Line 2

Town

Postcode

Phone number

Your email address

Your Skills and Interests

Interest Groups

Please list which groups you are considering joining. Also please indicate if you have been told there is a waiting list

Partner of existing member?

No Yes

Are you the partner of an existing member at the same address?

Are you willing to volunteer now or at a later date?

Yes No

We are run by volunteers!

Are you an ongoing member of another U3A?

No Yes

For full members of another u3a. Discount £5.50

Receive printed copies of TNL

No Yes

Get a print copy of “The Northern Line” newsletter every term for £6 per year.

Additional donation (optional)

If you wish to make an additional donation please enter the amount above

Total amount due

Total: £

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 North London U3A reclaims on your donations in the tax year.

I am a UK tax payer and wish to Gift Aid this and all future donations that I make to North London 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.

Please do not claim Gift Aid on this subscription

Payment Method (Online Banking preferred please)

Online Banking: Pay to Sort Code: 60-06-26 Account Number: 87691469 Account Name: North London University of Third Age. When prompted please put your FULL NAME as a reference. If this is not done your payment cannot be recorded.

By Cheque: Cheque Payable to: North London U3A and sent to Membership Secretary at 22 Lichfield Way London NW11 6NJ.

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