MARLOW AND DISTRICT U3A Associate Membership Form 2010 Name : _____________________________________________________________ Address 1 : _____________________________________________________________ Address 2 : _____________________________________________________________ Address 3 : _____________________________________________________________ Postcode : ____________________ Telephone : _____________________________ E-mail : ______________________________________________________________ See below for costs Receive Newsletter & Updates by e-mail (tick as appropriate) Receive UPDATES ONLY by e-mail Associate Membership £8 pa (does not include entry to Monthly Meetings, but includes attendance at the Summer Outing, the Christmas Event and Open Afternoon) Please add £9 pa to contribute to the cost if you prefer your Newsletter to be printed & posted each time rather than sent as an attachment to an email TOTAL £ Annual Subscription for April 1 2010 to March 31 2011 Please send this form with a SAE and a cheque made payable to Marlow and District U3A to:The Treasurer, Brian Humphrey, 10 Squirrel Rise, Marlow Bottom, SL7 3PN. (01628-484099) Thank you. The success of our U3A depends upon the members being willing to learn and to teach. We have produced this membership form in order to discover the interests and hidden talents of our members. We would be most grateful if you could complete this form in the spirit in which it was produced. TALENTS AND SKILLS : ______________________________________________________ HOBBIES AND INTERESTS : __________________________________________________ PLEASE INDICATE IF YOU ARE WILLING TO : Start or Lead an Interest Group (on the subject of) : _____________________________________ Serve on our Committee (as) : _______________________________________________________ Provide expert advice (Please state subject) : ___________________________________________ Give a talk at a Monthly Meeting (on) : ________________________________________________ Give a vote of Thanks : ____________________________________________________________ I understand that this information will be stored electronically and used solely for U3A purposes. Signature :____________________________________________________ Date : _____________ ------------------------------------------------------------------------------------------------------------------------------ (U3A use only) Receipt No : _____________________ Membership No ________________________________