vU3A Membership
Application Form

  Help
Please take a few minutes to fill in this application form. The information that you are giving will help us to get some idea of our members' interests and capabilities. Your email address will only be available to members of any group that you might join. Your address and phone number will not be given without your express permission. Please make sure you fill in all boxes marked with a *.

If you have already sent the application form
and just wish to pay, go straight to here
To go back to the home page click here
 
Title:
First name: *
Last name: *
Address1: *
Address2:
Address3:
Town:
Postcode: *
Country: *
Phone number:
Email address: *
Email address confirmation: *
Skype name if you have one:
Name of your U3A if a member:
To select the next three answers, click on the little down arrow and choose from the list
Your version of Windows:*
Which browser do you use?*
Email software:*
For questions below please click box for YES. Clicking again removes tick.
Do you use a PC?
Do you use a Mac?
Do you have broadband?
Can you read Word attachments to emails ?
Do you have loudspeakers?
Do you have a microphone?
If not, would you buy a microphone?
Do you know how to copy and paste?
Please record your interest in the following subject matter
Literature:
Visual arts:
History:
Science and technology:
Politics:
Music:
Architecture:
Other:
Special interests:
Finally
Would you like to help run the vU3A?
Would you like to lead an interest group?
Are you isolated in some way?
Are you a carer?
Do you have a mobility problem?
I am a UK tax payer and I want Virtual U3A to
claim back the tax on my annual subscription
now and in the future. This will not cost
you anything but will benefit vU3A.

 

Please select the present month:*
(as your joining month)
Enter - in the white box below - the letters you see here in the yellow box
security code



Enter the letters here:
 
Please check the accuracy of your entries on this form before clicking
on the button below to send in your application. If you get an error
message, use the browser's BACK button to correct it.