CYMDEITHAS HANES LLEOL RHUTHUN

RUTHIN LOCAL HISTORY SOCIETY

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I wish to join the Ruthin Local History Society. I agree that the information I provide can be used to send me details of the

Society and its activities. The Society undertakes that your data will only be used for these purposes and will be kept in confidence, and will not be shared with a third party.

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Name    ___________________________________________

Address    ________________________________________

        ______________________________________________

e-mail    ___________________________________________

Telephone  ________________________Date ___________

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BANKER’S ORDER.

TO:    BANK  ________________________________________

BRANCH ADDRESS  __________________________________

SORT CODE    _______________________________________

ACCOUNT NO.    _____________________________________

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PAY TO NATWEST BANK, RHUTHUN BRANCH, SORT CODE 54-41-06

ACCOUNT   RUTHIN LOCAL HISTORY SOCIETY

ACCOUNT NUMBER      22852840

THE SUM OF £5 / £10 * EACH YEAR STARTING ON 1ST. DAY OF

__________________________20_____ UNTIL FURTHER NOTICE.

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SIGNED    ______________________________ DATE  _______________

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PLEASE RETURN COMPLETED FORM TO THE SECRETARY, DAVID GARETH EVANS, ELIDAN, FFORDD LLANFAIR, RHUTHUN, LL15 1DA.               01824 704564  garethmachno@yahoo.co.uk 
*£5 per person

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