Your personal name:
  
Trading as name:
  
Address:
  
Town:
  
City:
  
Post Code:
  
Telephone:
  
Public E-mail (the one every one can contact you with):
  
Which listing do you want to appear under:

Type your advert here including links and emails:

 
 
A short message about your services, to get your site going:
  
Paying by card, enter type, Visa, Master, etc:

Issue Number SWITCH ONLY:

Card Number:
  
Card Security Code, last three digits in signature strip: 

Starts:
  (mm/yy)
and Expires:
  
Amount £10 for one year or £20 for three years £
  
Price includes maintenance and updating as you require.

We will debit your card once the listing has been uploaded.
This is for the first year or three years as specified.

Email this form to
weddingsinwales@live.co.uk

You can pay by card over the phone 01792 229191
Tuesdays to Fridays 9.30am till 1.00pm

Or post with your cheque payable to Galaxy Studios
The Weddings in Wales Website
Galaxy Studios
78 High Street
Gorseinon
Swansea SA4 4BL