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. Pay with StripePay with Paypal