U3A  Browns Bay Membership Application Form 

Please complete this form and mail to the Membership Manager at PO Box 35 851, Browns Bay, North Shore, 0630.

The annual subscription is payable after the application is accepted. Do not send money at this stage.

 

Applicant (1)…………………………………………Applicant (2)…………………………………

Address:…………………………………………………………………………………… 

Area code:………….… Phone:……………………     Email:…………………... ………...       

Where did you find out about U3A?………………………………………………

Name (1)    Which Special Interest Groups do you intend joining? 

Name (2)    Which Special Interest Groups do you intend joining?

 

 

 

 

 

 

 

 

Do you have any particular skills or interests you would be willing to share with others?

 

Annual subscriptions: Single  $30  (plus an initial joining fee of $5)... ... ... ... ... ... ... ...

 

                                  Double $60 (plus an initial joining fee of $5) (same address) ... ...

 

Members can choose their method of receiving the U3A  NEWSLETTER . . . .

     NEWSLETTER if delivered by NZ Post, there will be an additional charge of $10.00.

     NEWSLETTER if by email,  will be FREE.

      Do you want your newsletter by email or post?  ... ... ... ... ... ... ... ... ... ... ...

 

 

Sign Here:... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...

 

Date of Application: ... ... ... ... ... ... ... ... ... ... ... ... ... ...