Membership Application

Important:
Your membership application will be processed after we have received payment of the applicable fee.
After completing this application, please register for activities by clicking here then complete the online or pdf enrolment form.

Click here to view fees and payment options.

New Membership Application

This form is used by the public to apply for membership of Gawler U3A

Name(Required)

First Middle Last

Preferred Name

Year of Birth

Residential Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Postal Address if different to Residential

Address Line 2 City State / Province / Region ZIP / Postal Code

Enter Email Confirm Email

Mobile Phone

Home Phone

Emergency Contacts

1st Emergency Contact

Phone

Alternative Phone (if applicable)

2nd Contact (if applicable)

Phone

Alternative Phone (If applicable)

U3A Membership

Do you belong to another U3A

U3A Name

Payment

Please select the payment method ( Go to the Membership - General Information page for information on membership fees, payment methods and information regarding membership)(Required)

If a cheque payment please provide the cheque number

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