Bedford University of the Third Age

Chairman:   Pam Laycock

Registered Charity No 1042458

APPLICATION FOR MEMBERSHIP 2009/2010

Please complete using block capitals.

Title  ...........       Surname.............................. Date of Birth..................

Full Forenames...............................................Known as....................... 

Address..............................................................................................

.....................................................................Postcode......................

Telephone....................................................email.............................

The Third Age Trust

PLEASE ENCLOSE £15 SUBSCRIPTION FEE PER PERSON PAYABLE TO BEDFORD U3A

plus 2nd class stamp for return of membership card and new member's booklet

This form may be returned at an Open Meeting or by post to:

Membership Secretary: Mrs Pat Fowler, 14 High Street, Oakley, Beds, MK43 7RG  

                                         telephone: 01234 824474   email tricia@fowlers.me.uk

I enclose cheque for.........  

Signed........................................

Members details will be copied on to computer and will be used solely within Bedford U3A for administration purposes only

GIFT AID DECLARATION

I would like Bedford U3A to reclaim the tax on all subscriptions I have made this

tax year and may make in the future until I notify you otherwise, as Gift Aid donations.

                Signature:...............................                     Date:...........................

1.        You can cancel this Declaration at any time by notifying the Membership Secretary

          in writing

2.        This Gift Aid Declaration covers any payments that you have made to the U3A

          since April 2004  and   may  make   in  the  future,   including  single   donations

          and   membership subscriptions

3.        For your donation to qualify for Gift Aid you must pay an amount of income tax

          and/orcapital gains tax at least equal to the amount the Bedford U3A will reclaim

          on your donation within a tax year

4.        If you pay tax at the higher rate you can claim further tax relief in your Self

          Assessment tax return

5.        If in the future your circumstances change and you no longer pay tax on your

          income and capital gains equal to the tax that Bedford U3A reclaims, you can

          cancel your declaration

6.        Please notify Bedford U3A if you change your name or address