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Membership Renewal form

Renewals for the year 2020-2021 are due in April 2020. You will be sent an email from the Membership Secretary which will include the contact details which we hold on our database.

Please complete this form when you have received this email.

If you have a printer and are paying by cheque, click here to download the paper form, otherwise enter your details on this page.

If you have on-line banking, you can make a payment direct to our bank account. Complete and send the form below, then immediately log into your bank account and make the payment. When payment has been verified, the Membership Secretary will email confirmation of your membership renewal/post your membership card to you.

To change your contact details at any other time, click here to use the contact form.

Membership number (if known):

Title: Forename:

Preferred salutation:
if different from forename above

Surname:

Confirm or change your contact details

Tick to CHANGE any of my existing contact details.
If you do not tick this checkbox, you confirm that all your contact information and that of your emergency contact are unchanged, and that you agree that we may continue to use them.

Complete all the fields, including those which are to remain the same.

Address (including Postcode)

  Landline telephone number: ;
ex-Directory?

Mobile telephone number:

Email address:

Emergency contact

Name:

Telephone:


Charity Gift Aid Declaration

We are a charity. If you are a UK taxpayer, boost your donation by 25p of Gift Aid for every £1 you donate. Gift Aid is reclaimed by the charity from the tax you pay for the current tax year. To Gift Aid your donation you must tick the box below:

I want to Gift Aid my subscription to Maldon & District University of the Third Age, charity No 1086182

I am a UK taxpayer and understand that if I pay less Income Tax and / or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference.

Please notify us if you want to cancel this declaration, change your name or home address or no longer pay sufficient tax on your income and / or capital gains. If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.


Remarks

Now click on the appropriate option below:

a) I will pay by cheque.

b) I will pay by on-line banking bill payment.

The subscription is £ 20.00