Please provide your contact information and subscription payment method on this form. After you submit this application you will be provided with a link to our Course Participation form. Both are secure forms.
First Name:
Enter name preference for your membership badge
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Last Name:
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Street or PO Address:
Enter the number and name of street, or PO box number, in usual postal format
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Enter suburb name in full as published by Australia Post; shortened or colloquial names are invalid (OMIT street, PO box, NSW and postcode)
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Enter Australia Post postcode for the above suburb
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Email Address:
Our default means of quickly communicating Programs, Newsletters, course notifications to you
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Email Address check:
Please check and confirm your email address entry above, or that it has been left intentionally blank.
Landline Number:
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Mobile Number:
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Additional Information you would like held with your Membership record:
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Advising us how your subscription was paid is essential for cross-referencing our records. This is required before full LMU3A membership or enrolment in selected courses can be confirmed. Subscription instructions are detailed in our current Program or at
I have checked information entered above to be correct, and agree to abide by the policies, by-laws and constitution of Lake Macquarie U3A.
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