WAG MEMBERSHIP APPLICATION FORM 2005

Please complete all relevant fields.

All correspondence will be conducted electronically if possible.

Please complete and return this form with the relevant membership fee to: 

Georgia Anderegg
WAG Treasurer
13 Bangor Street
Cardiff CF24 3LQ
Tel: 029 20 481420

 

Membership fees:                       

 

·       Date ______________________________________________________________

·       Name (or company)_________________________________________________

·       Contact person (if relevant)  ___________________________________________

·       Address      __________________________________________________________

                     _________________________________________________________

                     _________________________________________________________

                     _________________________________________________________

·       Postcode     _____________________

·       Telephone Numbers:

          Home       _______________________________

          Work        _______________________________

          Mobile      _______________________________

          Fax          _______________________________

·       E-mail     ________________________________________________

·       Details:  (please tick)

     a) Are you:

          Student

          Animator

          Other  (please give details) _________________________________________________

b)   Are you:

          Animation company

          Self-Employed (freelance)

          Currently unemployed

          Other (please give details) __________________________________________________