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.


ASSOCIATE MEMBERSHIP APPLICATION AND RENEWAL FORM

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

Given Name…………………………………………..


Surname ………………………………………………


Address…………………………………………………….


…………………………………… Post Code…………….


Home Tel………………………..                           Mobile……………………


Email……………………………………………………………..


Parent U3A group    ………………………………………………………..


N.B. Proof of current U3A membership is required e.g. photocopy of or original U3A receipt or contact number of parent U3A group to enable confirmation.


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


Please circle    Associate Member  Renewal      or     New  Associate Member Application     

Annual Associate Membership  Fee             Single $10     Couple $20

Half Yearly Fee applies ONLY for applications or renewals after 1st July.

Half Yearly Associate Membership  Fee      Single $5        Couple $10


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 Mountain Inc. has Public Liability Insurance to age 80 – max $10 million.


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