NEW MEMBER APPLICATION
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.
CONTACT DETAILS
First Name:
Enter name preference for your membership badge
Your answer
Last Name:
Your answer
Street or PO Address:
Enter the number and name of street, or PO box number, in usual postal format
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Suburb:
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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Postcode:
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.
Required
Landline Number:
Omit area code
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Mobile Number:
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Additional Information you would like held with your Membership record:
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SUBSCRIPTION
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 http://lakemacquarie.u3anet.org.au/membership-enrolment/.
CHECK
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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