Cymdeithas Hanes Teuluoedd
Powys Family History Society

MEMBERSHIP APPLICATION FORM (Postal)
Member of the Federation of Family History Societies.
Member of Association of Family History Societies of Wales
Charity No.511875

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(BLOCK CAPITALS, PLEASE)

Title / Full Name(s): ................................................................................................

Address: .................................................................................................................
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Post / Zipcode: ............................................ Country: ...........................................

E-mail Address: .............................@.......................................... Date: ....................

I / We wish to become a member(s) of Powys FHS - and enclose the relevant subscription fee:

Type A:	[_]	Individual / Family UK / Ireland membership	GBP 12.00 per annum
Type B:	[_]	Overseas membership	GBP 15.00 per annum

please tick appropriate box

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NEW MEMBERS' INTERESTS - (BLOCK CAPITALS, PLEASE)

Surname	Forenames	Parish/Area	County	Year
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Your 'Interests' will appear in the first available issue of the Society's journal 'Cronicl Powys'

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UNITED KINGDOM DATA PROTECTION ACTS
The personal information you provide will be kept on a computer file. To comply with the above Acts please indicate below whether or not you object to this. The information will not be used for any other purpose

I / We object [_] - I / We do not object [_]

PAYMENT: please send cheques (Sterling only) payable to 'Powys Family History Society' together with the completed form to: Mrs Angela Jones. Membership Secretary.
'Briar Patch', The Ridgeway, Penally, TENBY. Pembrokeshire SA70 7RJ

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