Founded 1994
Membership form 2006
Name
__________________________________________________________________________________________________
(Block Capitals please) Mr.Mrs./Miss/Ms./Rev./Dr.
Address
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Tel
__________________________________________________________________________________________________
Email
______________________________________________________________________________Please write clearly
Signature:-
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Annual Subscription
15.00 or $20 us dollars or $25 australian Dollars
Payable on 1st January
Please print out form and send with paymentof 15 to :-
Cork Genealogical Society,
C/o Olive Coleman,
22 Elm Drive,
Shamrock Lawn,
Douglas,
Cork,
Rep. of Ireland.
payment can be made with cheque equivalent in own currency to save on bankdraft charges.
Use www.xe.com to find exchange rate.
Office use only
Date
.
Reg.no
.. Cash.cheque
.
