This is the Application and Gift Aid form for 2027. Please fill in all relevant details. When you submit the form it will be sent directly to the Membership Secretary. A green confirmation notice will appear below.

Member Details

Membership Number

Title

Forename 1

Surname 1

Email 1

Phone 1

Second Member (Optional)

Forename 2

Surname 2

Email 2

Phone2

Address

Address Line 1

Address Line 2

Town/City

County

Postcode

Membership Amount

£12.00 – Members who access the Newsletter via the Website (per person).£17.00 – Annual Membership fee per person requiring a Postal Newsletter£24.00 – Membership for two people who access the Newsletter on the Website.£29.00 – Membership for two people at the same household requiring a Postal Newsletter.

Payment Method

Bank TransferCheque

We will send the BACs details for payment on or after 1st October.

Gift Aid

I AGREE to make a GIFT AID Contribution and have read all the relevant information on the website regarding my contribution.NO to GIFT AID

Third Age Magazine

YESNO

Agreement

I agree to abide by the Pembrokeshire U3A Constitution and Terms and Conditions.

Date

Signature or Full Name

Have you provided contact details such as email or phone?
This helps us contact you if needed.

Tick this box to continue.