Please enable JavaScript in your browser to complete this form. - Step 1 of 3Name Member 1 *FirstLastEmail *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeTelephoneMobileEmergency Contact Details 1NextMember 2 at same addressFirstLastEmailTelephoneMobileEmergency Contact Details 2NextPayment *Bank transfer to sort code 40-41-22, account number 81449354 (please add your name as reference)Cheque to 'Shepton Mallet U3A'. Please add 50p bank handling charge.N/AMembership Fees: Please select payment method above. £14.00 per person per year (1st September-31st August) or £7.00 per half year (1st March-31st August) Our newsletter will be sent by email. Payment by bank transfer is preferred but cheques may be sent to the treasurer as follows: Jane Burman SMU3A Treasurer 6 Carlton Court Princes Road Shepton Mallet BA4 5JYLink to Ts and Cs Membership Application *Yes I/We apply for membership of Shepton Mallet U3A and confirm that I/We will abide by the terms of membership as stated above. I/We confirm that I/We have completed the form myself/ourselves. I/We will make full payment of fees due.No, I/We are not applying for membershipThird Age Trust Magazine *Yes I wish to receive the Third Age Trust magazine.No I do not wish to receive the Third Age Trust magazine.Data ConsentThe information you have supplied will be used 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 the Third Age Trust to communicate with you as a member. - For the distribution of the Third Age Trust Magazine.Privacy Statement *I/we consent to my/our data being used for membership purposes as detailed above.I/we DO NOT CONSENT to my/our data being used for membership purposes as detailed above. If this option is selected, we cannot process your application for membership.Please be advised that you can request for your data not to be used for any of these purposes at any time by contacting us: Email: jane.burman@btinternet.com Telephone: 01749 342924If you have not already done so we would appreciate it if you would fill in a Gift Aid form.Submit
