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* 1. Enw llawn / Full name

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* 2. Cyfeiriad cartref / Home address:

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* 3. Rhif ffon / Phone number

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* 4. Ebost / Email

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* 5. Capsiwn llun a lleoliad / Caption and location

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* 6. Uwchlwythwch eich llun / Upload your image.

PDF, PNG, JPG, JPEG file types only.

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* 7. Unrhyw nodiadau eraill / Any other notes