Membership Application

Please fill in the form below or download the PDF version, fill it in and send it to the address on the PDF.

Family Name:(Required)

Given Name:(Required)

Address:(Required)

Suburb:(Required)

Postcode:(Required)

Phone:(Required)

Email:(Required)

Emergency Contacts

Name:(Required)

Phone:(Required)

Please note the 2 questions below is for insurance purposes only and your privacy will be respected.

Do you have a disability?

Yes

Are you 95 years or over?

Yes

Membership Information

Membership Fee - $30 per year. (If you join on or after the 30th September you will be financial until the end of the following year)
Payment option available is via direct payment online. Bank details are provided at the bottom of this page and on the confirmation email.

Membership

Price:

Class information

For information about classes please email - secretary@u3aherveybay.net or phone 0431 366 264

I would like to be enrolled in the following classes:

NB: Your enrolment is subject to number availability. Please contact the relevant class tutor for confirmation.

Tutor Information

Would you like to be a Tutor?

Yes

If you answered yes to being a tutor, what subject could you offer?

How did you hear about U3A Hervey Bay?

Applicant's Agreement

Date:(Required)

Confirmation(Required)

By ticking this box you agree to the terms of the constitution, policies and by-laws of U3A Hervey Bay Inc.

I agree to the terms of the constitution, policies and by-laws of U3A Hervey Bay Inc. I acknowledge that I have read the terms of the constitution, the policies and the by-laws of U3A Hervey Bay.

Payment Options

Online:
U3A Hervey Bay
BSB: 633-000
A/c No 169 687 654
[please enter your name in reference section]
or
Deposit at any branch of the Bendigo Bank

The University of the Third Age

Hervey Bay Inc.

Membership Application

Membership Information

Class information

Tutor Information

Applicant's Agreement

Payment Options

Contact Us

U3A Hervey Bay

Tutor Information

Other Useful Resources