Membership Form

Annual Memberships

Basic Membership $15.00
Family Membership $20.00
Supporting Membership $25.00
Sustaining Membership $50.00
Patron $100.00

Lifetime Memberships

Individual Life Membership $225.00
Family Life Membership $300.00

Annual Organization Memberships

Affiliated Organization Membership $25.00
Supporting Organization Membership $50.00
Sustaining Organization Membership $100.00
Patron Organization $250.00

Annual memberships are good from June 30th to June 30th of each year. Annual memberships purchased now will be valid until June 1, 2010. GPWHP is a 501(c)(3) non-profit organization. Your donations are tax deductible.

Name __________________________________________________________________________

Address (1) _____________________________________________________________________

Address (2) _____________________________________________________________________

City ____________________________________________________________________________

State/Province/ County _____________________________________________________________

Zip/Postal Code ___________________________________________________________________

Telephone ______________________________ Email ____________________________________

What is your connection to Welsh Heritage? ______________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Make Checks to GPWHP

Mail form, with check to: GPWHP, PO Box 253, Wymore, NE 68466

Diolch yn fawr iawn!        Thank you very much!