WBU MEMBERSHIP RENEWAL THIS FORM SHOULD ONLY BE USED FOR WBU MEMBERSHIP RENEWAL Personal Details First Name* Last Name* Address Telephone (Home/Mob) Email WBU Number* - if you're unsure of this please contact your Club Secretary Affiliation Details Primary Club (this must be a Club 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 [group group-426] ....and provide any alternative NBO number Please choose who should administer your Master Point Account WBUEBUSBUNIBUCBAI [/group] Payment Details: Annual Membership (associated with a Club) - £18 Annual Direct Membership - £25 Junior - £1 [group group-127] 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 [/group] Amount to Pay (WBU Membership + Area Fees)* £ (If this renewal 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'