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					                                      CARDIGANSHIRE Family History Society
                                     Cymdeithas Hanes Teuluoedd CEREDIGION

                       APPLICATION FOR MEMBERSHIP / CAIS AELODAETH
                 (please complete in CAPITAL letters / llythrennau BRAS os gwelwch yn dda)

          I/We wish to apply for membership of the Society – Carwn ymaelodi a’r Gymdeithas

Title (Mr/Mrs/Ms. Etc)/Teitl …………………………………………..
Surname/Cyfenw ………………………………………………..…….
Forenames/Enw(au) ……………………………………………………
Address/ Cyfeiriad ……………………………………………………………………
…………………………………………………………………………………………
County/State/Sir ………………………………………………………………….
Post Code/Zip Code/Cod Post ………………………………………………
Country/ Gwlad …………………………………………………………………..
Telephone No./Rhif ffôn: ………………………………………………….
(Not to be disclosed/ Ni ddatgelir)
E-mail address/e-bost ………………………………………………………
Please indicate your level of experience: - Beginner / Average / Experienced (delete as appropriate)

Type of membership/Math o Aelodaeth
Individual (UK and EC residents only)                                                                            £8.00
Family (husband, wife, non-adult children at same address)                                                      £10.00
Overseas, single or family, (other than EC)                                                                     £11.00
UK Institutions (plus £4 per extra copy of Journal)                                                              £8.00
O/S Institutions (plus £7 per extra copy of Journal)                                                            £11.00
Student (U/25 in full-time education)                                                                            £6.00

I/We enclose the appropriate payment of £ …………..
Amgaeaf fy nhaliad o
(Sterling only, cheques, etc. payable to ‘Cardiganshire FHS’)


To conform with requirements of the Data Protection Act please answer the following questions:
1: The Society’s records are held on computer, for Society use ONLY. Do you object to having your details held
   in this way, YES / NO
2: Do you have any objection to the Society printing this information in the Journal, YES / NO


Signed/Arwyddwyd . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   Date/Dyddiad. . . . . . . . . . . .
* Please note that the ‘membership year’ runs from January to December.




Please send the completed form, with payment to:                       Menna H Evans,
Dychwelwch y ffurflen i                                                Hon Sec., Cardiganshire FHS,
                                                                       C/o Collection Services
                                                                       National Library of Wales
                                                                       Aberystwyth,
                                                                       Ceredigion, SY23 3BU

				
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