Couples Registration Form

This page is for couples who wish to register for BNB U3A for the first time. If you are an individual new member or existing member, please go to the main registration page HERE.

PLEASE ENSURE YOU ENTER ALL REQUIRED DATA BEFORE CLICKING THE PAYMENT BUTTON TO COMPLETE PAYMENT, AND DON'T FORGET TO ENTER THE 2ND PARTNER'S DETAILS AFTER PAYMENT BY CLICKING THE BUTTON AT THE BOTTOM OF THIS PAGE.

NOTE: YOU DO NOT NEED A PAYPAL ACCOUNT TO COMPLETE A PAYMENT BY CARD, SCROLL DOWN ON THE PAYMENT SECTION TO CHOOSE THE DEBIT/CREDIT CARD OPTION.

Membership Levels

Membership options for couples - Standard membership is for the whole year, but if you are a member of another local U3A the reduced fee is applicable. (Associate Member)

Both partners will have to register as individuals in order for us to register your details when you first join. Once registered, your annual renewal can be done using the main form, where only one of the partners has to complete the form and payment.

Couples - Initial Registration *

Couples Standard - £ 28.00

Couples Associate Member - £ 18.00

Total Amount

Insert here the titles of each partner (e.g. Mr & Mrs) and the first initial of each partner (e.g. R & S for Richard and Sue). Required to properly address your Third Age Matters Magazine and other postal communications. Then complete the rest of the name and address of you as the first partner before selecting the PayPal payment button.

Couples Information

Enter the term to be used for you as a couple, e.g. Mr & Mrs

Couples Title *

Enter here the first initial for each partner, e.g. R & S

Initials *

First Name (1st Partner) *

Last Name *

Email (Primary)

Address Line 1 *

Address Line 2

Address Line 3

Address Line 4

City/Town *

Postal Code *

Group Preferences - Please select which Interest Group(s) you are interested in joining, or suggest an alternative group you would be interested in.

Group Preferences *

Please define any alternative Interest Group you might be interested in:

Alternative Interest Group

How did you find out about us? *

Gift Aid Declaration

After reading the following statement, please tick ONE option to confirm you wish to Gift Aid your membership subscription, or select NO if it does not apply:

I am a UK tax payer and understand that if I pay less Income Tax and/or Capital Gains Tax for each Tax Year (6 April to 5 April) than the amount of Gift Aid claimed on my membership subscription in that tax year it is my responsibility to pay the difference. I understand that the charity will claim 25p on every £1 of my subscription.

Can we Claim Gift Aid? *

Yes, today and in the future

No

Yes, This year's subscription only

Preferred Communication Methods

Your name and contact details will be used only to communicate with you on U3A business. Please select the preferred communication method(s) here

Preferred Communication Method

Phone
Email
Postal Mail
SMS

PAYMENT BUTTON BELOW: You do not need a Paypal account to pay using the Paypal process - select the Paypal Checkout button below to pay by debit/credit card

By completing the Membership Registration/Renewal form you are agreeing to the above Terms and Conditions and the Data Protection/Privacy Policies.

DON'T FORGET TO TICK THE BOXES TO APPROVE THE POLICIES BEFORE PAYMENT AND ENTER THE 2ND PARTNER'S DETAILS AFTER PAYMENT BY CLICKING THE BUTTON AT THE BOTTOM OF THIS PAGE.

u3a

Bulkington, Nuneaton and Bedworth

New Member Signup - Couples only

NOTE: YOU DO NOT NEED A PAYPAL ACCOUNT TO COMPLETE A PAYMENT BY CARD, SCROLL DOWN ON THE PAYMENT SECTION TO CHOOSE THE DEBIT/CREDIT CARD OPTION.

Preferred Communication Methods