Join Us!

Please use the form below to apply for Membership. Alternatively, If you would like a paper form or have any question about our membership, please contact our membership secretary Liz Barnes via email membership@fetchamu3a.org.uk or call 01372 375163.

New Membership Application Form

Title and First Name

Last Name

Address

Town/City

Postcode

Home Telephone

Mobile Telephone

Email Address

My Emergency Contact's Name

My Emergency Contact's Telephone

I would like to 'Gift Aid' my Subscription and I have read the 'Gift Aid' declaration below.

Yes

By ticking the 'Yes', you declare that:
"I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference"

Is there a second Member at this address?

Yes

Second Member Name (Title, First, Last)

Second Member Mobile Telephone

Second Member Email Address

Second Member Emergency Contact's Name

Second Member Emergency Contact's Telephone

Second member would like to 'Gift Aid' Subscription and has read the 'Gift Aid' declaration above.

Yes

Postal Renewal Please (I/we don't have an email address or can't print)

Yes

I/we will pay by: (£17, or £30 for two Members' at the same address) Payment Instructions will be available after you click "Submit"

Cheque or Cash

Bank Transfer or Standing Order

Direct Debit

How did you hear about us?

Thanks!

Website Information

01372 375163
info@fetchamu3a.org.uk