Irish American Society of Tidewater

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	Membership

Membership is open to persons of Irish birth or ancestry as well as those persons who have an interest in Irish history and culture.

The Annual membership contribution is for one year and includes twelve issues of The Irish Connection newsletter.

Membersip fees are as flollows:

$20.00 per Single individual
$25.00 per Family (includes children under 18)

Please complete the following application, print and return with payment to the Irish American Society.

Make checks payable to the Irish American Society of Tidewater.

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		The Irish American Society of Tidewater Membership Application


Type of Membership:
Single (20$) Family (25$)	Date:
Name:
Address:
City:	State:	ZiP:
Phone:
Email:

Are you a native of Ireland?		If so, what county?
Yes No
If Irish - American, What county of ancestry?

Birth date and/or wedding anniversary for each family member (for noting in newsletter)
Name:	Date:		Name:	Date:

	Mail to:
	Irish American Society of Tidewater c/o Mike Bromley, President P.O. Box 9614 Virginia Beach, VA 23450

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