Please pay Aylesbury Vale u3a, sort code 30-90-38, account number 00728902.

Please note the "Submit" button does not make the payment, you must do this separately.

Fee £16 per person or £16.91 if you would like us to post your membership card to you. Membership renewal for two plus postage = £32.91

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Aylesbury Vale u3a, Charity No. 1035640

Name *

First

Last

Email *

Postcode *

us original Postcode

Name of 2nd person if applying for 2

Postcode of 2nd person (if applicable)

Please let us know below if any details in your original application or last renewal have changed

I confirm acceptance of the conditions agreed to in my original application *

• Ticked to confirm

Date of application *

Membership Fee *

• One person - £16.00
• Two people - £32.00
• One person + postage - £16.91
• Two people + postage - £32.91

Please pay Aylesbury Vale u3a, sort code 30-90-38, account number 00728902. Select a postage option to receive your membership card(s) by post. Please note the "Submit" button is for the form only, the payment must be made separately via your bank.

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