Membership Application Form
(Please print clearly)

Name:
Address:
Tel.:
Email:

Date:
Signature:

I would like the newsletter sent by email (please tick)

If you are an allotment holder - name of allotment site

________________ No. of plot:______

Membership

Waged..............................€10.00
Unwaged............................€5.00
Family (2 or more)............€18.00
Group/Organisation Rate...€30.00

Amount enclosed:_________
(Cheque/postal order made payable to 'South Dublin Allotments Association')

Please post form and payment to: Membership Secretary, c/o 18 Elmcastle Park, Kilnamanagh, Dublin 24.