West Oxford
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                                             THE UNIVERSITY OF THE THIRD AGE


                                 2016-2017 ANNUAL MEMBERSHIP APPLICATION


To join/renew please complete the application form and return it to Mrs. Liz Jones, 3a Cumnor
Hill, Oxford OX2 9EU, together with your cheque, made payable to West Oxford U3A, for 15
per member and A STAMPED, ADDRESSED ENVELOPE, minimum 6”x 4 for the return of
your membership card.

Please complete the application in block capitals. 

Title …………            First Name................................. Surname..........................................

Spouse/Partner (if also joining) ...........................................................................................

Address ..............................................................................................................................

............................................................................................................................................

Post Code ..........................................................................................................................

Telephone number...............................................................................................................

E-mail address  ...................................................................................................................


Which special interest groups would you consider joining?..................................................

I understand that when I undertake any of the activities associated with U3A I do so at my own risk.

                                                                                

gift aid image                     

      The support we receive from HMRC’s
      Gift Aid scheme is important to the
      finances of our U3A.  If possible, please
      sign the following declaration.
   

 Gift Aid declaration: 

Please treat as Gift Aid donations all qualifying gifts of money made by me to West Oxford U3A
today or in the future.  

 I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year that is at 
least equal to the amount of tax that all the charities or Community Amateur Sports Clubs that I donate to will
reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not
qualify. I understand the charity will reclaim 25p of tax for every 1 that I give.

 
Signed ...............................................    Date ...........................................

 
Signed ...............................................    Date ...........................................

                        West Oxford U3A is a Registered Charity,  Number 1108125