CAIS AM AELODAETH
MEMBERSHIP APPLICATION
FFURFLEN GAIS - APPLICATION FORM
Anfonwch eich siec neu'r Archeb Banc at:
Return your cheque or the completed Bankers Order to:
Y Trysorydd/ The Treasurer
Rob Kenwell
Oak Bank
Rowen
LL32 8TS
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For the Gift Aid Declaration please
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Ar gyfer y Datganiad Rhodd Cymorth
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ARCHEB BANC
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At: Y Rheolwr
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Banc .........................................................................................ccc
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Dyddiad ....................................................................................
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Cangen .....................................................................................
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Côd didoli .................................................................................
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Talwch, os gwelwch yn dda. o fy nghyfrif i, i HSBC, Cangen Llandudno (40-30-18) i gyfrif Cymdeithas Treftadaeth Dyffryn Conwy, (cyfrif rhif 40247138) y swm o £............. YN SYTH ac yna ar 6 Ebrill bob blwyddyn hyd oni byddaf yn diddymu'r gorchymyn hwn.
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Llofnod..........................................................................................
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Rhif y cyfrif...................................................................................
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Dyddiad..........................................................................................
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Cyfeiriad..........................................................................................
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Côd post............................................................................................
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BANKERS ORDER
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To: The Manager
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............................................................................................................Bank plc
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Date....................................................................................................
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Branch ..............................................................................................
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Sort Code: .........................................................................................
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Please pay from my account to HSBC Llandudno Branch (40-30-18) for the account of Conwy Valley Civic Society, (Account number 40247138) the sum of: £.................NOW and on the 6th April next and annually thereafter until I cancel this instruction.​
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Signed ...............................................................................................​
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Account Number ............................................................................​
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Date: ...................................................................................................
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Address .............................................................................................
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Post Code .........................................................................................
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