IRISH DEMOCRATIC LEAGUE CLUB HASLINGDEN
(Michael Davitt Branch)
APPLICATION FOR ASSOCIATE MEMBERSHIP

Membership Card

Membership Rules

Membership Includes

membership number & card
copies of historical documents
a personalised email address
( yourname@thelandleague.org )

Membership Fees:

UK & Ireland Members £15 GBP pa
Overseas Members: $25 USD pa
All prices include P+P

Payment methods accepted:

Credit/Debit Card via Paypal
Pay by Cheque (UK Only)

(*required)

*First Name:

*Surname:

*Date of Birth:

Occupation:

*Address:
including
zip / post code

*Country:

*E-mail:

Telephone:

Mobile:

Please select one of the following:

	I was born in Ireland
	One or both of my parents were born in Ireland
	One or both of my grandparents were born in Ireland
	I am of Irish descent
	I just want to advance my Irish cultural heritage

*I promise to be an honourable and upright member and not besmirch the good name of the Irish Democratic League Club that I will represent as an Associate Member.

Please Select Payment Method

Debit/Credit Card

Cheque (UK Only)

Personalised E-Mail Address:
(optional)

@thelandleague.org

Terms & Conditions:
Any misleading information given on this form risks rejection of membership
Should your application be unsuccessful your membership fee will be refunded.

Please allow up to 14 working days to receive your membership pack subject to acceptance.
Personalised e-mail addresses are subject to availability.

This Organisation Recieves Funding from the Irish Government Emigrant Support Programme

IRISH DEMOCRATIC LEAGUE CLUB HASLINGDEN (Michael Davitt Branch) APPLICATION FOR ASSOCIATE MEMBERSHIP

IRISH DEMOCRATIC LEAGUE CLUB HASLINGDEN
(Michael Davitt Branch)
APPLICATION FOR ASSOCIATE MEMBERSHIP