St. Mary's GAA Club Cahersiveen
Membership Form
 

Please print out the following ,complete in block letters and send to :
 John Sugrue, Legal  Aid Board, Cahersiveen Co. Kerry. 

For information Email:  john Sugrue
Personal Details
Surname:                                                           
Forename:                                                           
Address:                                                                                                                                 
                                                                                                                                
Date:                                     
Email                                                                                                                          
 
ANNUAL SUBSCRIPTION Rates
Single :€30
Husband and Wife €50
Membership Fee can be paid by Postal order, Cheque (R.O.I Only) or Direct Debit. If Direct Debit is required please continue below.

BANKERS ORDER
 BANK ____________________BRANCH_______________
ADDRESS_________________________________________
__________________________________________________

 I/We authorise you to debit my/our account and to pay to: BOI, Church  Street, Cahersiveen
Co. Kerry, Sort Code: 90-56-51
For the Subscriptions account of the ST MARYS GAA  Club A/C Number 48644878
The sum of €________________
Per Annum, commencing on the   ____/_____/_______ (day/month/year)
continuing until further notice or cancellation by me in writing.


Signed:__________________________Date :    ___________
_______________________________________________________________________

© St Mary's GAA CLUB 2003