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Membership Application


Family Last Name:____________________________________________________
 
 
First Name(s):________________________________________________________
 
 
Address:_______________________________________________________________________
 
 
Town: _________________________________  
  
 
State ____________    Zip _____________________
 
 
Telephone ________________________________________________________
 

Membership dues are $25 per year.
Please enclose a check made payable to: Irish Cultural Society

 
Please print and return this page, along with dues, to:
Irish Cultural Society
P.O. Box 247
Garden City, NY  11730