Membership Application Form


Name(s).....................................................................................


Address......................................................................................


.............................................................................................


Post Code..........................................................................


Telephnone.........................................................................


Email.....................................................................................  

I/We would like to enrol as members of


Cymdeithas Hanes

EIFIONYDD

History Society


I/We enclose  a cheque for £.......................


(see panel on left for appropriate subscription amount)


Cheques to be  made payable to :-

Cymdeithas Hanes Eifionydd History Society


  Detach this form & send it with your remittance to:-

Michael Richardson , Membership Sec

Cymdeithas Hanes Eifionydd History Society,

Hafod y Bryn

Criccieth,

LL52 0AH

Single

£5

Couple

£7.50