Online Membership Application

Individual £20 per annum, Joint £35, Dual £15 (50% reduction after 1 October)

1. I understand that Westerham u3a (Wu3a) is an educational charity, run by its members who are all
volunteers. It works for the benefit of people in the Westerham area, and others who may live
further afield.
2. I wish to apply for membership for the current year and I will send a cheque made payable to
Westerham u3a to The Membership Secretary, Ruslyn, 72 Chestnut Copse, Oxted, RH8 0JJ.
Alternatively, an online payment can be made to the account of Westerham U3A at Sort Code: 60 19 02, Account Number: 23217960.
3. I agree to abide by the rules of the organisation.
4. I am not in full-time paid employment.
5. I understand that these details will be held on a computer database, and will be printed in a
membership list, which is available only to the Committee and for emailing/printing of labels used
in distributing U3A news and newsletters.

Please complete all required fields:

* Indicates required field

Name *

First

Last

Email *

Address *

Postcode *

Phone Number *

Payment *

I will pay by cheque I will make an on-line payment

Choose Any *

Please tick this box to give permission for the u3a to use your details to contact you for the purposes specified in 5. above. NB if you do not give permission, you may not be able to receive ANY communications from Westerham u3a. A copy of Wu3a’s Data Protection Policy is available on www.westerhamu3a.org. I give permission for any photograph that includes me to be used for publicity purposes and I understand that it is my responsibility to inform the photographer if I do not want my photo included

Gift Aid declaration – for past, present and future donations
Name of Charity: Westerham U3A
Please treat as Gift Aid donations all qualifying gifts of money made

Tick all boxes you wish to apply *

Today In the past 4 years In the Future

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year
(6th April to 5th April) that is at least equal to the amount of tax that all the charities or Community
Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I
understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity
will reclaim 25p of tax on every £1 that I give on or after 6th April 2016.

Name *

First

Last

Address *

Postcode *

Date *

Please notify Westerham u3a if you:
• Want to cancel this declaration
• Change your name or home address
• No longer pay sufficient tax on your income and/or capital gains

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to
you, you must include all your Gift Aid donations on your Self Assessment tax return or ask HM Revenue
and Customs to adjust your tax code.

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New Membership Application Form