EMERALD ASSOCIATION APPLICATION FOR MEMBERSHIP
I hereby apply for membership in the Emerald
Association of Putnam County, State of New York, and make each of the following
statements of fact, personally known to me,
intending that the Association rely upon the truth of each in acting upon this
application.
Member Information:
Name(s):
Street Address:
City:
State: Zip Code:
E-Mail Address:
Names & Ages of Children:
Brief History of Irish Ancestry:
Preferred method of
communication from the Emerald Association: qUS Mail q
E-Mail
How
did you learn about the Emerald Association?
q
By Member |
q
Please enter name: |
_______________________________ |
q
Website |
q
A Feis |
q
News Release |
q
Another Organization |
q
Special Events |
q
Newsletter |
q
Other |
________________________ |
|
Please Indicate the Committee(s) You Are Willing to Serve On (check all that
apply):
q
Membership |
q
Programs |
q
Publicity |
q
New Member Orientation |
q
Community Relations |
q
Welfare |
q
Website |
q
Scholarship |
q
Newsletter |
q
Special Events |
q
Feis |
q
Board of Directors |
q
Parade |
q
Dance |
q
Other |
If elected to membership, I
agree to abide by and be governed by the Constitution and By-Laws
of the Emerald Association and any future amendments,
modifications, and changes thereto.
Signature:
Date:
Annual Dues - January
through December (please indicate category):
q
Family - $25
q Single -
$15
Return Application: The Emerald Association of Putnam County, P.O.Box 141, Brewster, NY 10509;
or to Membership Secretary, Rose Kelly,
502 Seven Fields Lane, Reed Farm, Brewster, NY 10509