Cheltenham U3A

Cheltenham U3A Membership Application 2012

Charity Number 299146

Title _{. . . . . . .} Forename _{. . . . . . . . . . . . . . . . . . . . . .} Surname _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}

Address _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}

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Postcode _{. . . . . . . . . . . . . . . . . . . . .} Telephone _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}

email Address _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}

Our membership year runs from 1 January to 31 December.

I enclose cash / cheque payable to Cheltenham U3A for £_{. . . . .} Date _{. . . . . . . . . . . .}

Please return this form to Database Manager, Gerry McAllister, Clevelands, Ashley Road, Cheltenham, Glos, GL52 6PG

Please allow up to 28 days for your membership to be processed.
By signing this form, you give permission for us to enter the above details only into our database, in accordance with the Data Protection rights of individuals, kept secure and used only for U3A contact purposes. (Web form)

For office use only: Recorded Info pack Membership No

Cheltenham U3A Gift Aid

Charity Number 299146

If you are a taxpayer and willing to Gift Aid your subscription please complete this form and sign the Declaration below. Please note that this form will be separated from your membership application, and passed to our gift aid secretary.

Title _{. . . . . . .} Forenames _{. . . . . . . . . . . . . . . . . . . . . .} Surname _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . .}

Address _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .}

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Postcode _{. . . . . . . . . . . . . . . . . . . . .}

I am a taxpayer and I want Cheltenham U3A to treat all donations I have made since April 2000, and all donations I make from the date of this declaration until I notify you otherwise, as Gift Aid Donations.

Signed _{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .} Date _{. . . . . . . . . . . . . . .}

For office use only Membership Number: