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Annual Fee Form

Annual Fee Form

U3A Okeover 2023

You can either:

  • fill in the form below and click the "Send Annual Fee Application" button to submit your enrolment to us online, or
  • print the form, fill it out on paper, and hand your annual fee form to the treasurer at the desk.

Please hand your enrolment form to the treasurer at the desk.

Your Name(s):

You can use this form for the annual fee for one or two members.

Enter member name(s):
Member 1
Member 2

 

Annual Fee

Annual Membership ($25.00 )

Payment

Total Due
__________

Payment Method

x
Via Internet or Phone banking into account No 03-1594-0108506-00 (Please ensure you enter a surname and initial)

Questions/Comments:


Your Contact Details

Please provide your contact details, so that we can contact you in relation to this application:

Name:

Email:

Complete these details only if they have changed:

Address:


Post Code:


Phone:

Emergency Contact:

Emergency Phone:

Signature: