Membership Application

NAME:

MAILING ADDRESS:

PHONE:

E-MAIL:

WELSH CONNECTION:

WEBSITE OR BLOG (URL):

TYPE OF MEMBERSHIP:

LIFETIME MEMBERSHIP (15 times the annual membership):

ORGANIZATION MEMBERSHIP: POINT OF CONTACT (with title, if any):

METHOD OF PAYMENT:

In the UK, contact:

The Honorary Secretary in Wales
Dulais Rhys
9 St. David's Avenue
Carmarthen
Carmarthenshire
SA31 3DW

Email: SCCAemail.gif

Phone: SCCAphone.gif

Website in Wales: Sefydliad Cenedlaethol Cymru-America