WBU MEMBERSHIP RENEWAL via CLUB

THIS FORM SHOULD ONLY BE USED FOR WBU MEMBERSHIP RENEWAL SUBMITTED BY A CLUB ON BEHALF OF ITS MEMBERS

The form should not be used for those members who have changed their personal details (address, email, etc.); they should use the individual renewal form.

Club Details

Club Name* ---AberaeronAbergavennyAberystwythArchway (Ch)BarrivaleBridgendBreconCardiffCardiganCarmarthenCastle (Welshpool)Colwyn BayCowbridge (Old Hall)CricciethCrickhowellDinas & NewportGwent AcademyHaverfordwestKnightonLampeterLetterstonLisvaneLlandudnoLlanelliLlanfairfechanMenai (ABC)Merlins BridgeMG-OnlineMid GlamorganMoldMonmouthNewtownPark ViewPembrokePenarthPencoedPenrhyndeudraethPort TalbotPorthcawlPwllheliRhayader & LlandrindodRhiwbinaSwanseaSullyTenbyVale Of GlamorganWrexhamYnys Mon

Area Association* - please choose one        ---East - temporary concessionMid - temporary concessionNorth - temporary concessionWest - temporary concession

Member Details

First Name                     Second Name                               WBU Number  Additional Area                    Amount Due (£10 +                                                                                                                                                                              Area + Additional Area)
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 
          ---(East Wales - £0)(Mid Wales - £0)(North Wales - £0)(West Wales - £0)    £ 

                                                                                                                                         Amount to Pay*:           £

The WBU holds member's personal details for the purpose of administering their WBU Membership.
In addition, occasionally we would like to send them information on news and events. Their personal details will not be divulged to a third party or similar (See WBU Privacy Policy). Please confirm that the names above have been advised, and accept.

Submitted by*:       Email*:   
on behalf of the aforementioned Club.

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