Write a description of your survey here. Select any question below to change it. Then add questions as needed.

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* 1. Name

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* 2. Address

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* 3. Mobile

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* 4. Email

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* 5. How many Executive Patron Memberships? £270 each.

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* 6. How many Stand Memberships? £110 each.

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* 7. How many Senior Memberships? £100 each.

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* 8. I would like Swansea RFC to send me information about events, offer and news by Email, SMS and Post.

Upon completion of the form, we will get in touch to arrange payment.

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