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Please fill in the form below to sign up

Are You a Welsh Speaker?	Yes No
Title	Mr Mrs Miss Ms Rev'd Other
(if Other, please specify)
First Name(s)	*
Last Name	*
Date of Birth
Address Type	Home Church Organisation Office Business Other *
(If Other Address, please specify)
Address	*
Postcode
Main Phone (including area code)	*
Mobile Phone
Fax No
Main Email	*
Secondary Email
Website
Add to our Links page?	Yes No
Do you work in the voluntary sector?	Yes No
(Is it Christian or Secular voluntary work?)	Christian Secular
I would like to become a	Member Friend
Fill out the following if you wish to be a Member: (£25 one off registration cheque to be sent in the post if you are one of the few who wish sign up and are not exempt from this fee as covered in the membership section of the web site)
Please select one or more of the membership options (Please note: it is possible to apply for all three options to save you time on form filling)
Are you exempt from the membership fee?	Yes No
I would like to be a Personal member?	Yes No
I would like to be an Organisation Member?	Yes No
Organisation Name
Organisation Officer	Yes No
Organisation Office Held
Purpose of your Organisation
Are you the only rep for your Organisation?	Yes No
I would like to be a Church Member?	Yes No
Church Name
Are you a Church leader?	Yes No
Church Office Held
Denomination
Are you a Denomination head?	Yes No
Send me Gweini Newsletters	Yes No
Can we send info to you by email?	Yes No
I would like to pray for Gweini	Yes No
Do you want to receive event emails?	Yes No

You should receive an e-mail confirmation of your application within 2 weeks. If you do not receive it please contact us at info@gweini.org.uk

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