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Membership type/ Math o aelodaeth

The Friends of Clwyd-Powys Archaeological Trust Membership 2014-2015 Cyfeillion Ymddiriedolaeth Archaeolegol Clwyd-Powys Aelodaeth 2014-2015

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Membership type/ Math o aelodaeth

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  1. The Friends of Clwyd-Powys Archaeological Trust Membership 2014-2015 Cyfeillion Ymddiriedolaeth Archaeolegol Clwyd-Powys Aelodaeth 2014-2015 Personal information / Gwybodaeth bersonol Full name & title / Enw llawn a theitl _____________________________________________ Date of birth / Dyddiad geni_______/_____/_______ Address & Postcode / Cyfeiriad a chôd post _____________________________________________ _____________________________________________ E-Mail / E-bost_______________________________ Telephone no. / Rhif ffôn______________________ Mobile /Ffôn symudol (optional/dewisol)____________________________ Please send this form to / Anfonwch y ffurflen hon i Clwyd-Powys Archaeological Trust, 41 Broad Street, Welshpool, SY21 7RR • Membership type/ Math o aelodaeth • For overseas membership please refer to separate form/Am aelodaeth tramor cyfeiriwch at ffurflen ar wahân os gwelwch yn dda • Adults (per person)/ Oedolion (y pen) £10 • Concession / Consesiwn £8 • Institution / Sefydliad £20 • qCash / Arian parod • qCheque: Make cheque payable to Clwyd-Powys • Archaeological Trust or CPAT / • Siec: Gwnewch siec yn daladwy i • Ymddiriedolaeth Archaeolegol Clwyd- Powys neu • CPAT • Money transfer / Trosglwyddiad arian: • NatWest Bank, Broad Street, Welshpool • Sort Code: 55-70-40 • A/c number: 05509025 • A/c name: The Clwyd Powys Archaeological • Trust – A Registered Charity • Membership fees of £ _____________________for membership 2014-2015/ • Ffioedd aelodaeth o £ _____________________am aelodaeth 2014-2015. • (Optional) Also additional donation of £_______/ • (Dewisol) Hefyd rhodd ychwanegol o £ ________ • Please treat this and future donations as Gift Aid /Trin hyn, a rhoddion yn y dyfodol, fel Cymorth Rhodd os gwelwch yn dda.  I am interesting in the following activities (select as many as you desire)/ Mae gennyf ddiddordeb yn y gweithgareddau canlynol (dewiswch gymaint ag y dymunwch) Writings, books, papers /  Research / Ymchwil  Ysgrifau, llyfrau, papurau Photography / Ffotograffiaeth  Archive / Archif  Fieldwork / Gwaith maes  Mapping / Mapio  Education, Outreach / Addysg, Allgymorth  Historic buildings / Adeiladau hanesyddol  Other / Arall_________________________________ I am willing to participate on a committee to help with The Friends of CPAT organization (Select all that apply)/ Yr wyf yn barod i gymryd rhan ar bwyllgor i helpu gyda sefydliad Cyfeillion CPAT (Dewiswch bob un sy'n berthnasol) Grants / Grantiau  Finance / Cyllid  Organisation / Sefydliad  Membership / Aelodaeth  Programme / Rhaglen  Fundraiser / Codwr arian  Events / Digwyddiadau  Other / Arall_________________________________ Signature / Llofnod_______________________

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