U3A CAPE TOWN

APPLICATION FORM

Name ..................................................................................................................................................

Postal Address .....................................................................................................................................

...........................................................................................................................................................

......................................................................................................... Post Code ..................................

Telephone   .......................................................  Cell ..........................................................................

E-mail   ...............................................................................................................................................

I acknowledge that my participation in any U3A activity is entirely at my own risk. I will not hold U3A liable for any loss or damage to myself or my property.


Signed ......................................................................       Date ............../.........................../ 20............


Annual membership fee of R30 allows virtually free access to courses and meetings of any U3A.

Please complete this form and

a) Hand it in with your fee at a U3A General Meeting OR

b) Post it with a cheque made out to U3A to: U3A, PO Box 2135, 7740 Clareinch.

Membership cards may be obtained at a U3A General Meeting or by sending a stamped, self-addressed envelope to PO Box 2135, 7740 Clareinch.

In order for our organisation to grow further, we depend on a steady supply of willing and able course leaders / co-ordinators. Would you offer to share your expertise with a group, or ask a friend to do so?

Comments: .....................................................................................................................................

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For Treasurer’s use:

Membership fees paid :  R...................................  Date   .............................

Voluntary donation:        R...................................

Receipt Number .................................................  Membership Number ..................................


Receipt No Year Receipt No Year Receipt No Year Receipt No Year