WEST WALES DOWSERS SOCIETY
CYMDEITHAS DAROGANWYR
GORLLEWIN CYMRU
SOCIETY MEMBERSHIP
APPLICATION FORM
First Name:
..
Surname:
..
Address:
.
.
Post Code:
.
.
Telephone No:
..
Are you currently a member of the British Society of Dowsers?
YES / NO
Do you consent to your Name/Address/Tel No. being published in our
Newsletter?
YES / NO
Annual Membership Subscription:
£12.00 per individual
Partner Rate:
£ 12.00 for second
person at same address.
Junior Membership:
£
6.00 (11 16 years old).
If Junior membership, please advise date of birth:
.
Dowsing Experience (please tick as
appropriate):
None
____
A little
____
Experienced
____
Professional
____
Dowsing Interests (please tick any of
the subjects that interest you):
Underground Water, Cables, Pipes, etc
____
Archaeology and Ancient Sites
____
Standing Stones
____
Earth Energies
____
Other interests (please state)
______________________________________________
Do you have any previous organisational experience that may be helpful in a
Committee Position at a future date?
(You
do not have to answer this but any information supplied in this box will be
treated as confidential)
____________________________________________________________________________________
____________________________________________________________________________________
Payment to
be sent (with this form) to:
.
Cheques/Postal Orders to be made payable to
West Wales Dowsers Society.
If posting,
a receipt will be included with the next Newsletter.
Signed:
________________________
Date: ___________________
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For Treasurers Use:
Date Received: ____________
Receipt No: ______
Seq No: ______