NAME

ADDRESS





POSTCODE

TELEPHONE  No

SHOTGUN CERTIFICATE No …………………………………   EXPIRY DATE ……………………………..

I hereby apply for membership of the Dyfi and District Wildfowlers Association and do hereby agree to abide by the rules and
conditions of the association.

I further agree to pay the annual fees if my application is successful, and to give notice prior to the end of the membership year should I at any time decide to terminate my membership.


SIGNED……………………………………..

DATE………………………………………..


PROPOSED BY…………………………….

SECONDED BY……………………………

APPROVED BY COMMITTEE ON THE………………………………………