FLEET AND DISTRICT University of the Third Age

Membership Renewal Application Form for 2013/14 Please complete this form and send it with your subscription to the Membership Secretary: 62 Dukes Mead, Fleet, Hampshire. GU51 4HE Please tick the appropriate box. I am RENEWING my membership

my number is ………………….…….

PERSONAL DETAILS (please use BLOCK CAPITALS) Title: ……………

First name: ………………………………………..……… Surname: …………………………..……………………

Address: ……………………………………………………………………………………………………………………………………………………… Postal Town: ………………………………………

County: …………………………………….. Post Code: ……………………

Telephone Number: ……………………………………………… E-mail address [please print in capitals]: ……………………………………………………………………………………………….. I enclose a cheque or cash for the sum of £7.50 per member [ from 1st April 2014 ] Cheques should be made payable to Fleet U3A – please don’t send cash in the post. Alternatively, an electronic transfer can be used to the Fleet U3A CAF Bank account as follows:Sort Code 40-52-40, Account number 00006405 & most importantly your Membership No. Reference Please tick this box if you have paid by this method

If any of your details change during the year please inform the Membership Secretary.

Membership Application Form Notes Are You a UK Taxpayer? If so you can make your eligible membership fees go further by completing the declaration overleaf. Because Fleet and District U3A is a registered charity [No. 1055104] we are able to treat your membership fee as a Gift Aid Donation. Can I claim Gift Aid for my spouse’s membership fee? Each member who is a taxpayer (even if retired drawing a pension) is entitled to Gift Aid their subscription to Fleet and District U3A as it is a charity. If you are a couple and you are both taxpayers then each of you needs to complete the Gift Aid form. However, if one of the couple is a taxpayer and the other is not we can only claim Gift Aid on the taxpayer’s subscription even if he or she pays both subscription fees. This is because the HMRC view the payment of a subscription fee for a non-taxpayer by a tax payer as a gift to that individual not to the charity. Change in your details Please notify the Membership Secretary if you change your name, address, telephone number, e-mail address or your Gift Aid status. UK Data Protection Act. Personal information supplied on this form will be held by Fleet and District U3A on a computer system and used for administration purposes only. Office Use only

Received: ………………………. Membership Card and Programme posted:

Fleet U3A – Renewal Application Form 2013-14

Entered onto database:

Registered Charity 1055104

Revised March 2014

FLEET AND DISTRICT University of the Third Age

Gift Aid Declaration Please treat as Gift Aid donations all qualifying gifts of money made Today and in the future Please tick box. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) 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 on every £1 that I give on or after 6 April 2008. Donor’s details Title ……………….. First name or initial(s) ……………………………………………………………………………………………………. Surname ………………………………………………………….. Full home address …………………………………………………………………………………………………………………………………….. Postcode …………………………….. Date ……………………………………. Signature ………………………………………………………… Please notify the membership secretary if you: • Want to cancel this declaration • Change your name or home address • 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. Thank you! Membership Secretary: 62 Dukes Mead, Fleet, Hampshire. GU51 4HE Email: [email protected] Membership Enquiries: Telephone: 0845 872 3623

Fleet U3A – Renewal Application Form 2013-14

Registered Charity 1055104

Revised March 2014