Chelmsford u3a Membership Application Form

Membership year 1st March - Last day of February

Your Details

Name (Full Name) Preferred Name

Your Address

Address – First Line Address – Second Line Address – Third Line Address – Fourth Line Postcode

Contact Details

Email Address To reduce costs, the committee will communicate with you via email where possible. Phone Number
How did you first find out about the u3a?

Membership Fees

The fees for Individual membership include a £4.00 membership fee paid to our national organisation, the Third Age Trust, which provides a wide range of services and benefits, including liability insurance cover. Affiliated members pay this through their parent u3a. Membership fees are payable for/by (please select one and give details where necessary):
Membership Type

If you chose Affiliated Membership please complete Name of Other u3a Membership Number at Other u3a

Payment Method

U3A Chelmsford. Sort Code 08-92-99 Account No 67361669 Reference; Your Name and NM for New Members.

TERMS AND CONDITIONS OF MEMBERSHIP

All members must:
• Abide by the Principles of the u3a movement.
• Always act in the best interests of the u3a and never do anything to bring the u3a into disrepute.
• Treat fellow members with respect and courtesy at all times.
• Advise the committee of any change in your personal details.
• Abide by the Member Code of Conduct
Chelmsford u3a is committed to ensuring that the u3a is as inclusive and accessible as possible for those in their third age who meet the criteria for membership. If you wish, please let the Membership Secretary know of any special needs or circumstances that may assist in helping us undertake this important commitment.

PRIVACY STATEMENT (please tick boxes for consent)

Chelmsford u3a processes member information so that we can keep you informed about events, groups and activities as part of your membership. Chelmsford u3a’s lawful basis for collecting this information is legitimate interest / contact. In processing your information Chelmsford u3a will:
• Store it securely
• Use it to communicate with you as a Chelmsford u3a member.
• Share your information with group leaders/convenors for those groups that you are a member of.
• Send you general information about the Third Age Trust*
*The Third Age Trust is the national office to which all u3as are affiliated.
Chelmsford u3a produces a monthly newsletter and sends general information by email (where possible) to reduce time and costs. If you want to receive these communications please tick the box below:

I consent to my data being used to share Chelmsford u3a newsletters and general information.

Chelmsford u3a arrange for Individual members to receive a copy of the Third Age Trust publication – Third Age Matters. Note, Affiliated members receive this through their parent u3a. Please confirm that you wish to be added to the direct mailing list for the magazine Third Age Matters by ticking the box below:

I consent to my data being shared with the company who oversee the distribution of the Third Age Matters

Please be advised that you can request for your data not to be used for the direct postal mailing of Third Age Matters, or Chelmsford u3a general communications at any time by contacting the Membership Secretary in writing (email acceptable).

I apply for membership of Chelmsford u3a and confirm that I will abide by the terms of membership as stated above. I confirm that I/We have completed the form myself or have been assisted to do so. I will make full payment of fees due as soon as is reasonably practicable.

Name Date
Please consider completing the gift aid form if you are a UK Tax payer, which enables Chelmsford u3a to reclaim the tax on your membership subscription.
Gift Aid?

Charity Gift Aid Declaration - Charity No.1027234 (please complete if eligible so Chelmsford u3a can receive gift aid)

I am a UK tax payer and wish to Gift Aid this and all future subscriptions and donations that I make to Chelmsford u3a, unless I notify you otherwise. I understand that I need to pay enough Income Tax or Capital Gains Tax in each tax year to cover the Gift Aid claimed on all my donations to charity, otherwise it is my responsibility to pay any difference. Title Forename Surname Address – First Line Address – Second Line Address – Third Line Address – Fourth Line Postcode
Please notify the Membership Secretary if you want to cancel this declaration.

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version 5 08/09/2025