U3A TAMBORINE MOUNTAIN INC.


Please print this form, complete the details and post to U3A Tamborine Mountain Inc.

P.O. Box  403, North Tamborine Qld. 4272.

with your cheque. money order or confirmation of payment by direct deposit


MEMBERSHIP APPLICATION AND RENEWAL FORM.

Members of U3A Tamborine Mountain Inc.
should be in active retirement or preparing for retirement.  
Yearly Subscription.  From 1
st January to 31st December.

Applications lodged after 1st July please See note below


Given Name ……………….................................…      


Surname ………………........................................……

   

Address………………………………........…………………………….


   …………………..............………………..  Post Code…………….


Home Tel…………..........…  Email…….................……………………………


Mobile………………...........…….


Nominated by  ............…………name.......……… ...........


Seconded by  ……......…………name.... ………........       The names of  nominator and seconder are required only for New member applications.   They are not necessary for membership renewal


I am interested in learning about………………………………………


I would consider tutoring in…………………………………………….


Please Circle  Renewal        or        New Member

Annual Fee         Single  $25                Couple  $40

Half Yearly Fee applies ONLY for applications or renewals after 1st July.
Half Yearly Fee   Single $12.50             Couple  $20

Signed……………………………………   Date:……………………….


Payment: By cheque or money order to : U3A Tamborine Mountain Inc.

                                                        P.O. Box  403, North Tamborine Qld. 4272.

Or Direct Debit to : Heritage Building Society, Nerang Branch

Account Name:  U3A Tamborine Mountain Inc.

                      BSB :  638070    Account No.  11130598


U3A Tamborine Mtn. Inc. holds $10 million Public Liability Insurance. Please note that Insurance is only to age 80.

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