APPLICATION FORM

CARMARTHENSHIRE ANTIQUARIAN SOCIETY

CYMDEITHAS HYNAFIAETHAU SIR GAERFYRDDIN

(Charity No. 260705)

APPLICATION FOR MEMBERSHIP:

Please print off a hard copy of this form and return it to the Mr Terry Wells, c/o Carmarthenshire Archive Service, Parc Myrddin, Richmond Terrace, Carmarthen, SA31 1DS, Tel. 01267 228232, email: twells@carmarthenshire.gov.uk

I/We wish to apply for membership of the Carms. Antiquarian Society and enclose Standing Order form, cash or cheque* herewith.

Name (BLOCK letters, please):...........................................................................

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Telephone  ...........................................   Email ...................................................

* please indicate if your name differs from the account name on your cheque