I'r Rheolwr/To the Manager: ...................................................................................................................................

Cyfeiriad/Address: ..................................................................................................................................................

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Taler ar unwaith ac yna ar y cyntaf o Ionawr bob blwyddyn i Banc Lloyds plc, Cangen y Farchnad, 802 Heol Oxford, Abertawe SA1 3KP
Please pay forthwith and on the first day of January each year to Lloyds Bank plc, Market Branch, 802 Oxford Street, Swansea SA1 3KP (côd dosbarthu/sorting code 30.95.46) y swm o/the sum of

£ ....................

i gredyd Cymdeithas Cerddoriaeth Cymru rhif cyfrif 0475785 nes rhoddir rhybudd pellach gennyf i.
for the credit of the The Guild for the Promotion of Welsh Music account no: 0475785 until further notice from me.

Llofnod/Signature ....................................................................................................................................................

Dyddiad/Date .....................................................

Cyfeiriad/Address ....................................................................................................................................................

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Anfoner y ffurlen hon i’r Ysgrifennydd:
Please send this form to the Secretary:

John H Lewis
9 Brown Street, Ferndale
Rhondda CF43 4SF

(Member’s annual subscription: individual £15; corporate/group £25; student £5)