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APPLICATION FOR MEMBERSHIP

Welcome to the Cape Welsh Society!

(Please use this form only for online applications. For printing it out, please use the pdf version - Click here)

When you have completed the form, click on the "Send" button at the bottom.

Primary Members Name: -

Name: -
Surname: -

Family members names: -

1.		Relationship: -
2.
3.
4.

Contact details: -

Address: -
Suburb: -
City: -
Code: -

Tel (home): -		Tel (work): -
Cellphone: -		e-Mail: -

Connection to Wales: -

I apply for membership of the Cape Cambrian Society (Cymdeithas Cymry y Penrhyn)
I am eligible for membership as below: (please tick appropriate box)

I am Welsh
by Birth

I am Welsh
by Descent

My Husband /
Wife is Welsh

I have been a
resident in Wales

I am interested in
Welsh Affairs

City, Town or District of Wales with which I am associated: -

If you would like to make any additional comments, please enter them here: -

I promise to uphold the constitution of the Cape Cambrian Society (Cymdeithias Cymry y Penrhyn) & pay the annual subscription when it becomes due at the beginning of each Calendar year, until my written resignation has been forwarded to the secretary.

Subscription Fees: -
	Single Member:	R 40
	Family:	R 50

Banking Details:

FIRST NATIONAL BANK
Account Name: Cape Welsh Society
Account Type: FNB Business
Branch: Table View Branch
Branch Code: 203809
Account No.: 6233 154 8894

When you click send, the form will be automatically sent
to the Membership secretary.