Cwm Dulais Historical Society

MEMBERSHIP FORM

 
To Join the Cwm Dulais Historical Society Fill in the form below, then print it and send both the form and your payment, either cheque (UK bank) or money order, to our membership secretary:
Please make cheque payable to: Cwmdulais Historical Society
Ron Williams, Membership secretary, 26 Moorlands, Dyffryn Cellwen, NEATH, SA10 9HU.
Please fill in the following fields:(fields in RED are required for us to be able to process your application)

 

 

Title

First Name

Last Name

Address line 1

Address line 2

Town/City

County

Post Code

Country

Telephone

Email address

 

 

Subscription details

 

 

 

I enclose subscription for:

 

 

 

full membership @ £6.00 per year  

 

 
Tick if you do NOT want your details held on computer.
Data Protection Act
Normally your details will be held on computer. Whilst the society will under no circumstances allow this information to be used except for society purposes, if you object to such information being hold on computer please tick the box above