Online Membership Application

JOIN US

Join online

To join now, complete our Online Membership Application below:

Application by Form

Alternatively, if you do not wish to submit your membership online, please download our Membership Application Form here and email or post it to us at the address on the form.

Download Membership Form - Pdf

Download Membership Form - Word

First Name

Surname

Address

Address - First Line

Address - Second Line

Address - Third Line

Address - Post Code

Contact Details

Your Email Address (see Note 1)

Your Telephone Number

Your Mobile Number

Emergency Contact Name (see Note 2)

Emergency Contact Phone Number

Emergency Contact Relationship

Membership Details

Please see the explainatory notes on Membership Fees and to determine the amount to pay.

Are you a member of another u3a?
NoYes

Name of Other u3a
(complete if you have answered yes to the above question)

Membership Number of Other u3a
(complete if you have answered yes to the above question)

Membership Type

Payment Method
I confirm that:
I have already paid by bank transferI will pay by bank transferI will pay by cheque or cash

Additional Information

1. How did you find out about our u3a?

2. Do you have any particular interests or skills you could bring to the u3a?

3. Which Interest Groups would you like to join? (see Note 3)

4. What new Interest Groups would you like to see in our u3a?

Terms and Conditions of Membership

Abide by the Principles of the u3a movement
Act in the best interests of the u3a and not bring the u3a into disrepute
Comply with the terms and conditions of the u3a and PRV u3a and their Policies, including the Health & Safety requirements - Click Here
Treat both fellow members and the public with respect and courtesy when undertaking u3a activities
Comply with and support the decisions of the elected committee and coordinators
Advise the Membership Secretary of any changes to your personal details
Accept that all activities undertaken within the u3a are at their own risk and accept responsibility to ensure their own fitness, health, physical limitations and clothing are appropriate to any activity being undertaken
Do not disclose fellow members personal contact details without permission

Confirmation

I have read and agree to the terms and conditions above and apply for membership of PRV u3a.

Whilst membership is open to all adults, please confirm you are aware that the primary focus of the u3a is older people and those no longer in full-time employment:

I consent for my personal data to be used for the purposes outlined in the Privacy Policy and the Data Protection Policy found at pontesbury.u3asite.uk

Signature

Signature (type your full name)

Date

Do you have any other queries you would like to raise?

Notes

To reduce costs, the committee will contact you via email where possible
Your emergency contact will only be contacted as per PRV u3a Privacy Policy and Data Protection Policy. Ensure your emergency contact has given their permission to share their personal data. Preferably, please provide a mobile number.
If you have any disability or condition that the coordinator of any interest group may need to take into account during your participation in the group, please bring this to the coordinator’s attention, so any reasonable adjustment can be considered.

Membership Fees

The full membership fee is £15.

The associate membership fee is £10. This is if you are already a full paid up member of another u3a.

Membership of the interest groups is free but will need a contribution to any expenses (e.g hall hire, refreshments etc).

Our membership year runs from 1st April to 31st March. If joining during the Membership year the fee amount is reduced as shown in the table below.

Joining in:	Apr to Sep	Oct to Jan	Feb to Mar*
Full Member	£15	£10	Free plus next year's subscription of £15
Associate Member	£10	£7	Free plus next year's subscription of £10

* If you are joining in February or March, these months are free together with payment of the next year's subscription. Effectively this will give you thirteen or fourteen months subscription for 12 months.

Bank Transfer
Preferably, please pay by bank transfer to TSB Bank
Sort Code: 77-66-74
Account Name: Pontesbury and Rea Valley District u3a
Account No: 02054660
Reference: Put the [YEAR] followed by your [Surname] and [First name] and, if possible, email the Membership Secretary to confirm you have paid.

Cheque
Alternatively, send a cheque payable to Pontesbury & Rea Valley District u3a to the Membership Secretary, stating your [full name] followed by [YEAR]:
Membership Secretary: Steve Anderson
Address: Thyme Cottage, Top Road, Pontesbury, SY5 0XZ

Queries

If you have any queries, please contact the Membership Secretary: