Register as a member of U3A

Name
Username*
First Name
Last Name
Nickname
Contact Info
E-mail* If you don't have or don't want to enter an email you must use a dummy value with the following syntax. [first letter of first name][lastname]@u3acalpedummy.com E.g. guy demeester => gdemeester@u3acalpedummy.com This is required because the system authentication is based on email addresses.
Website
About Yourself
Biographical Info
Password* Use 6 characters (one capital letter, small caps, and a few special characters until the medium security level is reached) Minimum length of 6 characters.
The password must have a minimum strength of MediumStrength indicator
Repeat Password*
Spanish Home Phone Number
Spanish Mobile Number
Home Phone Number
Home mobile number
Spanish address
Spanish address 2
Spanish street number
Spanish Postcode
Spanish Urbanization
Spanish Town
Spanish province
Home address
Home number
Home postcode
Home town
Home country
Can lead groups
- --Check if the member could lead groups--
Interested in joining committee
- --Check if user is interested in joining the committee--
Interests
Notes
Notes1
Membership number
I allow the website to collect and store the data I submit through this form.*
MailchimpBy checking this box I consent to the use of my information provided for email marketing purposes.
Join date
Honorary member
- --Check if member is a honorary member--
Life member
- --Check if a member is for life--