

CAIS AM AELODAETH
MEMBERSHIP APPLICATION
ARCHEB BANC
At: Y Rheolwr
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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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BANKERS ORDER
To: The Manager
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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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