New Membership Form

Wellington Irish Society

New Members

* Indicates required field

Name *

First

Last

Email/ Phone Number *

Address *

Enter your Address here or Your New Address if its Changed.

Authorisation *

Please add the name of the proposer and seconder

Type of Membership - Please Choose One *

Family - $40 Retired Couple - $20 Single (Waged) - $20 Single (Retired/Unwaged) - $10

Please Select your Membership Type

Submit