u3a Isle of Man — Membership Application

Fill in the form below, then select Send by Email. This will open your email program with the details already filled in, addressed to the Membership Secretary — just check it over and press send. If your device doesn't open an email program automatically, use Copy Details instead and paste them into an email yourself.

Your details

Full name

Address

Post code

Phone (landline/mobile)

Email address

Payment

Annual subscription: £20.00 — payable by bank transfer or cheque (see the Membership page for account details). Please make sure your payment reference is your first name and surname.

How are you paying?

Bank transfer Cheque Not yet paid

Date payment was made (if applicable). Membership cannot be confirmed until payment has been received.

Declarations I agree to abide by the Constitution and Rules of the u3a (IOM). I understand that personal information may be disclosed in confidence within study groups, and I undertake to respect such confidential information. I agree for u3a (IOM) to hold my details as given above for as long as I am a member, in line with the Privacy Policy. I do not wish to appear in photographs taken at Network or Group meetings for publicity purposes.

Signature

Type your full name to sign

Date

Typing your name here and submitting this form counts as your signature confirming the declarations above.