Huddersfield & District U3A
 CLASS ENROLMENT FORM

NOTES on completion  
Please enter your chosen class(es) in the rows headed 1st Class, 2nd Class or 3rd Class.
If you would like to provide an alternative choice, should any of these classes be full, please enter this choice in the  row headed Alternative.
Please send cheque or postal order with this form. If you have already paid your class fees to your Tutor before the end of last term, you should still include the details in the list below.
If you apply for more than two classes, you may be placed on a Waiting List.
Fees : £8.00 per class per term.

I enclose a cheque/P.O.  payable to 'Huddersfield & District U3A' for £ __________

Name (in caps)________________________   Mem. No._________Date_______
Address ______________________________________________

Please return to      U3A, Oldgate House, 2 Oldgate, Huddersfield  HD1 6QW       Tel : 225208

For Office use only
The panel below will be completed in the Office and returned to you as your Receipt
Thank you. We have  received your payment of £___________  You have been allocated a
place in the following Class(es) unless the final column states otherwise.

Signed________________________                    date ______________