membership

Plaid Cymru - The Party of Wales

Swansea West Branch Membership Application

Title…………………………………………………..

(Mr, Mrs, Miss, Ms, Dr, Other)

First Name(s)..........................................................…

Surname………………….…….

Address....................................................................................…

…………………………………………………………………………

Telephone (Home)……………………………….

Mobile:……………………….…….

Telephone (Work)……………………………………………………………………….

E-mail address……………………………………………………..

Occupation....................................................…………

Language of correspondence....................….(Welsh/English)

Payment Details

I would like to pay by: Cheque / Standing order_____________

Donation................................(£15, £25, £50, Other)

Any donation of £18.00 (£6.00 unwaged) includes membership

As the National Party of Wales, Plaid Cymru - The Party of Wales's aims are:

To promote the constitutional advancement of Wales with a view to attaining Full National Status for Wales within the European Union.

To ensure economic prosperity, social justice and the health of the natural environment, based on decentralist socialism.

To build a national community based on equal citizenship, respect for different traditions and cultures and the equal worth of all individuals, whatever their race, nationality, gender, colour, creed, sexuality, age, ability or social background.

To create a bilingual society by promoting the revival of the Welsh language.

To promote Wales's contribution to the global community and to attain membership of the United Nations.

I accept the aims and the constitution of Plaid Cymru the Party of Wales.

Signed……………………………………………Date: ………./………./………./

If rejoining- My Membership number is…………………………