Membership Application Form Name* Mr, Mrs, Ms, etc.MrMrsMissMsDrProf.Rev. Title First Name Last Name Address*Postcode*Email Phone*Subjects that interest you Architecture Art Badminton Bird & Wildlife Books/Reading Bridge Creative Writing Digital Photography Discussion Food/Eating Family Finders Family History Films French Gardening Historic London Visits Line Dancing Mah Jong Needlework & Patchwork Petanque Philosophy Poetry Science Scrabble Short Tennis Social History Table Tennis Music Walking Other You will not be held to these choices. It is just to give you an idea of the groups we run and us an idea of your interests.Your other interestsPlease list any other interests you may have.Gift Aid Yes I am a UK tax payer Please tick yes if you are a UK Tax payer, either income or capital gains, and would like BOC U3A to claim Gift Aid on your subscription and any gifts you may make.You have confirmed that you are a UK Tax payer and have paid tax at least the amount of your membership subscription and any future subscriptions and including any gifts of money that you make to Burnham-on-Crouch U3A from the date below and you are in agreement for Burnham-on-Crouch U3A to reclaim tax on your subscriptions and/or donations. Please be aware that HM Revenue & Customs may recover refunded tax from you if you haven’t paid enough income tax to cover the amount refunded.Agreement By ticking the 'I Agree' button below you are requesting membership of Burnham-on-Crouch U3A and agreeing that, if applicable, we can claim gift aid on your contributions. The membership secretary will contact you when your application has been considered.Confirmation I Agree Please prove you are a human! This iframe contains the logic required to handle Ajax powered Gravity Forms.