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MEMBERSHIP
Please print this form and send with the appropriate fee to one of the
addresses below. Alternatively you can follow the link opposite to a printer
friendly PDF file (You will need Adobe Acrobat Reader installed to view
the file which can be dowloaded at www.adobe.com
MEMBERSHIP APPLICATION FORM
Applications for membership should be
made to:
The Membership
Secretary
c/o 120 Harberton Park,
Belfast BT9 6TU
Northern Ireland
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Dr Donal O'Tierney
Belmont
41 Seaview Park
Warrenpoint
Co. Down BT34 3NJ
Northern Ireland |
Name:_______________________________________
Address:_____________________________________
____________________________________________
Post code:_________
Email address:________________________________
Telephone:___________________________________
Subscriptions
Annual Membership
|
£20.00 |
€25.00 |
| Student / OAP |
£10.00 |
€12.50 |
| Corporate |
£100.00 |
€125.00 |
| Overseas |
US$30.00 |
€40.00 |
Family membership
per person at the
same address
|
£15.00 |
€20.00 |
I wish to join the Irish Association and
enclose a cheque for £/€ ……………………
Signed …………………………………………………
Date: ………………………………………………….
New members are ratified by the committee
Please return completed form(s) to either the
membership secretary or Donal O'Tierney
New members will be ratified by the relevant committee
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