Membership


	Modified:


	Monday, March 24, 2008

St. David's Welsh Society of Nebraska Membership Application

Enclosed is my check for membership for the year 2002.

$7.50 Individual
$15.00 Family
$25.00 Sustaining
$300.00 Life (May be paid at one time or in five annual $60 installments.

Don't forget your luncheon Reservation!

Name & Title

Maiden Name

Address

City, St Zip

Telephone

e-mail address

Welsh Connection - Area or town in Wales? Other interesting information?


	Please fill in this form, print, and attach check payable to "St. David's Welsh Society" Send to :

Please fill out and print this form.
Make check payable to "St. David's Welsh Society"

Send to :

Stanley Owens
11027 Washington St.
Omaha, NE 68137


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