Ffurflen archebu ar gyfer Sgyrsiau Cymunedol / Booking form for Community Conversations

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DYDD IAU 6 TACHWEDD / THURSDAY 6 NOVEMBER

Canolfan Celfyddydau Minerva / Minerva Arts Centre:

Grŵp ffocws / Focus group: 12.30 - 2.30

Lluniaeth ysgafn ar gael /Light refreshments provided

Stryd Fawr, Llanidloes, SY18 6BY

High Street, Llanidloes, SY18 6BY

Enwau: / Names: *

Mudiad: / Organisation: *

Tref a Chod Post: / Town & postcode:

Ffôn: / Telephone:

E-bost: / Email:

Mae sesiwn grŵp ffocws yn cynnwys cinio / Focus group session includes lunch.

Bydd angen cinio arnaf. / I will require lunch.

Dim diolch. Ni fydd angen cinio arnaf / No thank you I will not be requiring lunch

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Gofynion eraill (e.e. mynediad, deiet, cyfathrebu, ayb) / Requirements (e.g. access, diet, communication etc)

Ydych chi'n defnyddio cadair olwyn? / Are you a wheelchair user?

Ym mha iaith y byddai'n well gennych chi gyfrannu?? / In which language would you prefer to contribute?

Cymraeg / Welsh

Saesneg / English

Yn ddwyieithog (Cymraeg a Saesneg) / Bi-lingually (English & Welsh)

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Er mwyn ein helpu gyda hysbysebu yn y dyfodol - ble gwelsoch chi'r hysbyseb am y digwyddiad hwn? To help us with future advertising - where did you see this event advertised?

Ticiwch un neu fwy o'r blychau os yw'n berthnasol / Tick one or more boxes if applicable

ebost PAVO / PAVO email

ebrief' PAVO / PAVO ebulletin

gwefan PAVO / PAVO website

PAVO Facebook

Other:

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