U3A Bromley Registered Charity No. 803461
APPLICATION FOR MEMBERSHIP RENEWAL,
AND GIFT AID DECLARATION
Please download this page on A4 size paper, and using BLOCK LETTERS complete a separate form for each person wishing to renew. Highlight any details which have changed in the last 2 years.
I wish to renew my membership of the U3A Bromley and enclose £10 as my subscription up to
31st December 2008. [Cheques should be made payable to U3A Bromley].
My membership No. is......................................
TITLE……........ FORENAMES ………...........................SURNAME.......................................
ADDRESS………………………………………………..............................……………………….
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……………………….......................................... ............POST CODE …………........…………
TEL No..................................................E-mail address….......................................................…
If you are a UK tax payer, every £1 of your membership fee is worth £1.28 to us because we are a charity. This extra money can help fund our activities. If you have not previously done so, please
complete and sign the Gift Aid Declaration below so that we can reclaim the tax.
Gift Aid Declaration
I would like the tax to be reclaimed on any membership subscriptions that I have ever made,
or will make, to the U3A Bromley until further notice. I confirm that I pay an amount of UK income tax or capital gains tax at least equal to the tax that the U3A Bromley will reclaim.
SIGNATURE…………………………………………..DATE……………….........…………….
This Declaration can be cancelled at any time by notifying the Membership Secretary in writing.
If you pay tax at the higher rate you can claim further tax relief on you Self Assessment tax return.
Please enclose a self-addressed envelope stamped 2nd class to:
Evelyn Robinson, U3A Membership Secretary, 45 Blackbrook Lane, Bromley BR2 8AU
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For Office use only
Membership No………….....… Admin No….........……… Date ………............Gift Aid..................