Crouch End & District

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Crouch End & District U3A Membership Application

Please select the type of membership you require
ConcessionFor those in receipt of means-tested benefits£ 5.00
Individual£ 35.00

Membership paid today continues until 1st January 2021

Then enter the following information. Fields in bold are mandatory.

About Yourself
Title      Forename      Surname       male female
E-mail      Mobile      Known as
Emergency contact
Upload photo (optional)      jpg, png, gif. Recommended max size 2MB
Own U3A (where you are a full member)
Tick if you pay UK tax and wish U3A to claim Gift Aid on your subscription (if applicable)
About Your Partner
Title      Forename      Surname       male female
E-mail      Mobile      Known as
Emergency contact
Upload photo (optional)      jpg, png, gif. Recommended max size 2MB
Your Address
No/Name      Street
Additional lines
Town      County      Postcode
Telephone
Payment

Amount to pay:  

Press the button below to proceed to PayPal to make payment
You may pay by credit or debit card or use a PayPal account
After payment, you should receive an e-mail from PayPal as a receipt and an e-mail from Crouch End & District U3A to confirm membership
The data you provide will be held electronically by Crouch End & District U3A to facilitate your membership.
If you have any concerns, please contact the Membership Secretary.
Problems or Enquiries?: membership@cedu3a.org.uk