Surname          
First Name          

Address             
Address             
Address             
Address             

Mobile no    086 087 085
Home Telephone no  

Date of birth:        day                   month                    year
                          1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31       January February March April May June July August September October November December          1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984  

Are you a Macra member ?         Yes         No

If you are a Macra member, which club are you a member of ?
none Ballynoe Midleton Ladysbridge Churchtown South Dungourney Bartlemy

What activities do you like to take part in, please tick one below

capers    debating    Farm tasks

plays

If you want to make any comments to about any Macra issues then please give your views below in the text box below, Or want to get in touch with any of our members.

Please type here