Membership Application

Membership Application Form

If you would like to join the Dorchester & District u3a, please complete the form below and click Submit. The current annual subscription is £15. We will hold your application pending receipt of payment.
Fields with an asterisk* must be completed in order to submit the form.

I wish to join the Dorchester & District U3A.

* Indicates required field

Name *

First

Last

Address *

Line 1

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City

State

Zip Code

Country

Phone Number *

Email *

Select Age Profile *

Occupation prior to ceasing full time employment *

Hobbies / Interests *

As a member, you will be entitled to receive the national Third Age Matters magazine *

I wish to receive the magazine I do not want to receive the magazine

Please select one of the payment options.

If you are setting up a regular payment (standing order) at your bank, please make payable to a/c Dorchester & District u3a, Sort Code 30-92-69, account no 01221849 (Lloyds Bank Dorchester). The first payment should be paid now and subsequent payments on 1st April annually.
If paying by online payment (BACS), please make payable to a/c Dorchester & District u3a, Sort Code 30-92-69, account no 01221849 (Lloyds Bank Dorchester).
If sending a cheque, please make payable to Dorchester & District u3a and send to Mrs Janet Kennewell, 16 High Trees, Broadmayne, Dorchester, DT2 8ER.

Payment options *

I am setting up a regular payment. I am making an online payment I am sending a cheque

By submitting this form, you are confirming that you wish to apply for membership of Dorchester & District u3a and that you will abide by the terms of membership as stated and have read the privacy statement (See below).

Submit

Terms and Conditions of Membership
All members must:

Abide by the Principles of the U3A movement.
Always act in the best interests of the U3A and never do anything to bring the U3A into disrepute. Abide by the terms and conditions of the constitution.
Treat fellow members with respect and courtesy at all times.
Comply with and support the decisions of the elected committee.
Advise of any change in your personal details.

Privacy Statement
By applying for membership, you are giving us permission to use the information you have supplied in the following ways:

To store it securely for membership purposes.
To communicate with you as a U3A member.
To share with Group Leaders for those groups that you are a member of.

Dorchester & District U3A will not pass this information to any other organisation without your permission.