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Cyn llofnodi'r eDdeiseb rhowch rhai manylion sylfaenol:

Mae'r blychau sydd â '*' yn orfodol.

* Enw cyntaf:

* Cyfenw:

* Eich e-bost:

* Cyfeiriad:

Address 2

* Town:

* County:

* Cod Post:

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