| APPLICATION FORM CARMARTHENSHIRE ANTIQUARIAN SOCIETY CYMDEITHAS HYNAFIAETHAU SIR GAERFYRDDIN (Charity No. 260705) APPLICATION FOR MEMBERSHIP: Please print off a hard copy of this form and return it to the Mr Terry Wells, c/o Carmarthenshire Archive Service, Parc Myrddin, Richmond Terrace, Carmarthen, SA31 1DS, Tel. 01267 228232, email: twells@carmarthenshire.gov.uk I/We wish to apply for membership of the Carms. Antiquarian Society and enclose Standing Order form, cash or cheque* herewith. Name (BLOCK letters, please):........................................................................... .......................................................................................................................... Address (with postcode)....................................................................................... ............................................................................................................................ ............................................................................................................................ Telephone ........................................... Email ................................................... * please indicate if your name differs from the account name on your cheque |