WELSH MINES PRESERVATION TRUST

YMDDIRIEDOLAETH CADWRAETH MWYNFEYDD CYMRU

APPLICATION FOR MEMBERSHIP 2018

Name ......................................................................................................................................................

Address ..................................................................................................................................................

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Postcode ..........................................................

Phone .....................................................................................................................................................

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I wish to renew my membership / become a member [delete as applicable] of the Welsh
Mines Preservation Trust for 2018, at a subscription, including surface-only insurance, of
£12.

Please note that the insurance covers surface activities only, and does not provide cover for any
activities underground.

I wish to receive future issues of the Newsletter on paper / in PDF (Adobe Acrobat
format), by e-mail / on CD [delete as applicable].

Your support of the Trust is greatly appreciated.

Please send this form and your cheque to

Peter White
Maesglas Uchaf
Ysbyty Ystwyth, Ystrad Meurig
Ceredigion SY25 6DD

To comply with the General Data Protection Regulations the personal information you
have entered on this form will be kept by the WMPT for membership and administration
purposes. Please sign below to authorise this.

Name Signature Date