CYMDEITHAS HANES TEULUOEDD GWENT
Registered Charity No.702333 (registered in England & Wales)
NEW MEMBER'S INTERESTS FORM
- Title
- Initials
- Surname
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Membership No.(If you are submitting this with an Application For Membership Form, your new membership number will be inserted by the Society)
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#Email Address
(ONLY if you wish us to publish it for you)Date
| MEMBERS' INTERESTS Print details in BLOCK CAPITALS of UP TO TEN names you are researching, which you wish to be included on our Members' Interests Database:- (if the surname is a common one, you can add forename(s), e.g. "JONES, ANN") |
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* Please ensure that you use the standard Chapman Codes
I wish the above details to be held by your Society on its Members' Interests Database. I understand that, if these details are accepted, they will be stored on computer and published, together with my contact details, initially in the Society Journal, also from time to time in the Members' Interests Directory, and may be passed, on request, to other researchers. Where the Society displays its Members' Interests on the Internet, I understand that mine can only be included if I give specific permission for this to be done.
I hereby therefore request that my interests as held by the society, and my postal & my email address shall be published on the Internet...
(You may delete either postal or email address from the above, but not both)
A
Whilst agreeing with their publication in the journal and directory, I hereby refuse to permit my interests and contact details to be published on the Internet.................................
B
Please return this completed form to:
The Membership Secretary, Gwent FHS, 5, Brookside, Bettws, Newport, Gwent, NP20 7EG
This section is for use by the Society's Officers
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- Checked by
- Date Received
- Date Processed