Membership Form

Club Membership Registration

Complete the form below to sign up for our membership. If you are just renewing your membership please do not complete this form but contact us via email info@leathermencymru.com letting us know your membership number.
Please ensure you cick the submit button at the bottom of the appliaction form.
* Required Information
First Name
Surname Name
E-mail
Address

Street Address

Street Address 2

CityState / Province

Postal / Zip Code
Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
State/Prov/Region
Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:

Country CodePhone Number
Birth Date:

DayMonthYear
Cymraeg
Are you a Welsh speaker?
Where did you hear about us?
Area I live in?
Membership
Membership is available to anyone 18 years of age or older.
Please select box to confirm
Please add a ID Photo

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Membership Fee
Membership fee is £15 per year. (subject to change)

Membership£15.00

This is for membership to LeatherMen Cymru

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By completing this form you agree to LeatherMen Cymru holding your personal data on file. LeatherMen Cymru does not sell data with third parties.
Once you submit your application and we have received your payment, we will contact you shortly to confirm your membership application and issue your electronic membership card.

Thank you!
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Club Membership Registration