WBU MEMBERSHIP APPLICATION

THIS FORM SHOULD ONLY BE USED IF APPLYING FOR NEW WBU MEMBERSHIP

Personal Details

First Name*

Last Name*

Male/Female
MaleFemaleNot Supplied

D.O.B

Address*

Telephone (Home/Mob)

Email

Affiliation Details

Primary Club (if applicable, the Club must be affiliated to the WBU) —Please choose an option—AberaeronAbergavennyAberystwythArchway (Ch)BarrivaleBridgendBreconCardiffCardiganCarmarthenColwyn BayCrickhowellGwent AcademyHaverfordwestKnightonLampeterLisvaneLlandudnoLlanelliMenai (ABC)Merlins BridgeMG-OnlineMid GlamorganMoldMonmouthNewtownPark ViewPembrokePenarthPwllheliRhiwbinaSwanseaTenbyVale Of GlamorganWrexhamYnys Mon

Please state if you are a member of another home union —Please choose an option—EBUSBUNIBUCBAI
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....and provide any alternative NBO number

Please choose who should administer your Master Point Account

WBUEBUSBUNIBUCBAI

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Payment Details:

Annual Membership (associated with a Club) - £18
Annual Direct Membership - £25
Junior - £1

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Non-Direct Members are also required to register with at least one WBU Affiliated Area (this should be the Area of their Primary Club - see Area/Club List):

East - £2.00
Mid - £2.00
North - £2.00
West - £2.00

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Amount to Pay (WBU Membership + Area Fees)*

£

(If this application is being requested by a third party - e.g. Club, please enter their name)  

The WBU holds your personal details for the purpose of administering your WBU Membership.
In addition, occasionally we would like to send you information on news and events. Your personal details will not be divulged to a third party or similar (See WBU Privacy Policy). Please confirm that you accept*
Payment for membership should be made by bank-transfer to:

Welsh Bridge Union
SC: 30-92-07
Acct: 01381335
Ref: 'Name (Abbrev)' + 'MF'