Form and payment test

Step 1 – complete the form using a fillable form

1a. Download the form.
1b. Open the form in Adobe Acrobat reader and fill in all the fields.
1c. Email us the completed form by pressing the ‘submit completed form’ bottom right.

Alternative step 1 – complete the form using an online form

Complete the form below and then press the submit button.

* indicates required field

Member details

First name*

Surname*

Gender

Email:*

Year of birth

Street address

Suburb

Postcode

Home phone

Mobile phone

Emergency contact name

Emergency contact phone

Occupational background

Skills areas

Course areas of interest

Annual subscription 2022

Already a member of another U3A?

If yes, name of main U3A

Member no. of main U3A

Amount paid

Paid by

Volunteering

Are you able to volunteer?

Possible volunteering areas

If tutor or other, what subject?

Signature

Double vaccinated for Covid 19?

Certificate cited?

Agree to official U3A photographs?

Date

Step 2 – pay the membership fee

Standard membership fee

$50.00

Pay membership fee

Associated membership

$25.00

Pay membership fee

Big Test

$1.00

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