FEDERATION OF LOCAL HISTORY SOCIETIES
SOCIETY MEMBERSHIP APPLICATION/RENEWAL FORM 2023
SOCIETY =====.Click here to enter text.
SECRETARY == .Click here to enter text.
ADDRESS ===== .Click here to enter text.
ADDRESS LINE 2 .Click here to enter text.
ADDRESS LINE 3 .Click here to enter text.
TELEPHONE NO. = .Click here to enter text. MOBILE . Click here to enter text.
OTHER CONTACT PHONE=.Click here to enter text.
E-MAIl .Click here to enter text.No. OF MEMBERS IN YOUR SOCIETY__Click here to enter text.
*FEDERATION MEMBERSHIP FEE PER ANNUM:
INDIVIDUAL: €10 40 MEMBERS OR LESS: €25 41+ MEMBERS: €50
*FEDERATION FEE==€ Click here to enter text. Cheques should be made payable to:
The Federation of Local History Societies and forwarded to;
Bernadette Doyle Cloonshivna, Oughterard, Straffan , Co. Kildare
OR Pay Direct to Federation Bank Acc. IBAN: IE15 AIBK 9333 6811 4890 83
YOU MUST INDICATE Which SOCIETY IS PAYING and Email TO firstname.lastname@example.org
Do you agree to?
- receive e-mails or other communications from FLHS Y/N? Yes .☐ No .☐
- have your e-mail address on our Website Y/N? Yes .☐ No.
- have your postal address in our Journal Y/N? Yes .☐ No.☐
Note: This form may be downloaded from the Federation Web Site,
Should your society require insurance cover please make direct contact with:
Arachas Corporate Brokers Ltd. And advise that you are a federation member
The Courtyard, Carmanhall Road, Sandyford Business Estate, Dublin 18.
Tel. No. 01 213 5000 E-mail email@example.com
Arachas Corporate Brokers Limited trading as Arachas, Capital IM is regulated by the Central Bank of Ireland.
Click here to download form