Membership / Contribution / Memorial Gift

Please fill out the form below and send it (along with check) to

Mr. Dick Myers, WGGAW Treasurer
9140 N Sycamore Ct.
Bayside, WI 53217

Name _____________________________________________

Address__________________________________________

City ___________________State_________Zip code______________

e-mail address____________________________________________

phone________________________________________________

______Please add my name to the Association mailing list.

         I would prefer to receive my WGGAW newsletter in electronic for by email at
the e-mail address  given above.  YES _____   NO______

_____ Enclosed is my donation to the Welsh Gymanfa Ganu Association of

Wisconsin in the amount of _________________.  I am a new member_______.

  I am a continuing member _________________.

I wish to designate _________________ as a memorial gift in honor of

________________________________________________________.

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