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 below to download form Save it. Then fill in details and save completed form and then attach to email to firstname.lastname@example.org