Exeter University of the Third Age

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					                Exeter University of the Third Age                                           Exeter University of the Third Age
                           Registered Charity No. 1104480                                             Registered Charity No. 1104480

                 Membership Form 2012                                                                      Gift Aid

                                                                              If you are a taxpayer and willing to Gift Aid your subscription
Title ………..      Forenames ………………………………………..…                                 please complete this form and sign the Declaration below. You can
                                                                              do this if you have paid at least £3 tax a year on income, savings or
Surname ………………………………………………………………..                                            dividends. Please note that this form will be separated from your
                                                                              membership form and passed to our treasurer.
Address ………………………………………………………………….
                                                                              Title …………         Forenames………….......………………………
          …………………………..…………………………………….
                                                                              Surname .…………………………………...........……………………
          …………………………………………………………………

Post Code …………………… Tel No ……………………………….                                       Address ...……………………………………………………..........….

e-mail address …………………………………………………………                                                   ………………………………………….........………………

Do you have special knowledge of, or interest in a subject to
                                                                                        …………………………………….........……………………
bring to U3A one day? ………………………………………………
                                                                              Post Code …………………………
……………………………………………………………………………..
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   One form per taxpayer please
only into our database, in accordance with the Data Protection rights of
individuals, kept secure and used only for U3A contact purposes.              I am a taxpayer and I want Exeter U3A to treat all donations
Our membership year runs from 1 January to 31 December.
                                                                              I have made since April 2000, and all donations I make from
                                                                              the date of this declaration until I notify you otherwise, as
I/we enclose cash /cheque (payable to Exeter U3A) for £_______                Gift Aid Donations.
(for 2012 £8 single membership: £14 for two at same address).

Please return this form and your subscription to the                          Signed ………………………………………                Date ………………….
membership secretary. Email exeteru3a@hotmail.co.uk for
address
                                                                              For Office use only:      Membership Number:
For office use only: Membership Number                Date:

				
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