Irish Cultural Society
Membership Application Form




Name:____________________________________________________________ 
 
Home Address ____________________________________________________
            Number and street  City           State    ZIP

Phone: (H)_______________(W)______________ Cell ____________________

E-mail Address: ___________________________________________________

Special Interest(s): Music___, Dance___, Genealogy___, 
History___, Other ______________________________________________
                        Check all that apply. If "other" describe.
What Activities would you like to help with?
Social Events___, Programs___, Publicity___, Membership___, Public Speaking___, 
News Letter ___, Fund Raising_____, Other_______________________
                        Check all that apply. If "other" describe

Yearly Dues: Family Membership: $25.00, Single $15.00, Associate (Non-Voting) $5.00
Guests and Visitors are FREE, and always welcomed.

This application form must accompany your check for annual dues.

Make Check Payable to: Irish Cultural Society
Mail to: Irish Cultural Society, 247 Patricia Dr.,San Antonio TX 78216



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