This form can be used by those wanting to join Carterton u3a or existing members who wish to renew their Membership.

Join or Renew? RenewalJoin

Individual or Joint? IndividualJoint

If you are already a member of another u3a please also select Associate and also name your parent u3a.
Associate member?Yes

Title —Please choose an option—Mr.Mrs.Ms.Dr.
First Name(s)
Family Name

Your email
Mobile number:
Landline:
Emergency Contact

Address Line 1
Address Line 2
Address Line 3
Post Code

Privacy Statement - Carterton U3A membership data is held on Beacon which is fully compliant with the
General Data Protection Regulations(GDPR). It is used for efficient administration it will also be
shared with Group Leaders and Third Age Trust for mailing of Third Age Matters. We will not pass any of the
held data to any other third party. By taking up the membership of Carterton U3A you agree to your personal
membership data being held as described above. If you have any objections, please speak to the Chair or
Treasurer.

Please indicate that you accept the privacy statement above by checking the appropriate box below:-

First Person I accept the above statement

Gift Aid Declaration If you are a UK taxpayer then Carterton U3A is allowed to make a Gift Aid claim on
your subscription. If you are agreeable to this then please sign the following declaration. This allows a
refund to CartertonU3A of the tax element of your membership fee. I am a UK taxpayer. Please treat as Gift Aid
donations all qualifying gifts of money made.

Please indicate that you accept the declaration above by checking the appropriate box below:-

First Person Yes, Please claim Gift AidNo, Do not claim Gift Aid

Note that we do not take payments online, see below for options to use once you have submitted your form.

Membership Fees 1st June 2024 to 31st May 2025 (All fees are 1/2 price after 1 December 2024

One Member £12

Joint Membership (Two members at the same address £24)

Associate Membership £8 each

Payable by:-
Bank Transfer to Carterton u3a Barclays Bank sort code 206520 account no. 73244083
Cheque to Membership Secretary, 123A Brize Norton Road, Minster Lovell, OX29 0SQ
Debit/Credit Card at Monthly meeting

I shall pay byBACS TransferDebit/Credit Card at meetingCheque

This box may be used for questions or comments (optional)