APPLICATION FOR MEMBERSHIP

(Fill in as completely as possible, then print out and mail - DO NOT EMAIL - to the address shown below)


Title (Mr., Mrs., Capt., Dr., The Hon., Lord, Tiarna)


Name
(Family Name, Christian Names, eg. Smith, David Randolph)



Address
(Street Address or PO Box)


City


State/County


Country


Postal Code

/ /
Home Telephone    /     Fax    /    Email address
(complete all applicable)

/ /
Work Telephone    /     Fax    /    Email address
(complete all applicable)


Full Name & Relationship to individual from whom you claim Irish descent (if applicable), including where in Ireland individual was from and when he emigrated:

Reason for Membership - Under which category are you applying? (check one)
Descendant of Soldier of French or Spanish Irish Brigade
Descendant of Soldier who served in a nominally Irish division of a foreign army
Descendant of Irishman who served in Army, Air Force, Navy or Marines
Personally served in a nominally Irish unit
Have an interest in the Irish foreign service

COMPLETE THE FOLLOWING AS THOROUGHLY AS POSSIBLE - USE ADDITIONAL SHEET(S) IF NECESSARY - ATTACH CURRICULUM VITAE IF AVAILABLE

/ /
Date of Birth
(MM/DD/YYYY)


Place of Birth
(City, State, Country)

Education (list Schools attended, type and dates of degrees received):

Military or Law Enforcement Experience (list Branch of Service, Rank attained, end date of service):

Military Awards/Decorations received:

Orders of Chivalry granted:

Associations currently involved with:


NAME EXACTLY AS YOU WISH IT TO APPEAR ON YOUR MEMBERSHIP CERTIFICATE
(may be in Gaelic - please include any necessary diacritical marks/fadhas - eg. An Ridire Ceannfort Dáibhi Raighilleigh O'Neil.)

_______________________________________________________
I hereby certify that the above information is true and accurate. Further, I understand that membership in The Honourable Society of the Irish Brigade involves a one-time application fee of $50US. Further, continuing membership requires an annual renewal fee of $25US, due June 1 of each year (regardless of the date of original membership), which entitles the member to continuing subscription to the Society's newsletter, The Brigade Bulletin, The International Journal of The Honourable Society of the Irish Brigade, published one or more times during the year. Annual Corporate membership is also available at  the entry level of $500US. Funds to be made payable to: The Honourable Society of the Irish Brigade.  

_______________________________________________________
Date

The submitting of this form does not in any way guarantee membership in The Honourable Society of the Irish Brigade. On review of this application and receipt of appropriate funds, you will be contacted via letter by the Commander as to the status of your application and membership.

NON-US APPLICANTS
The above completed application should be mailed to:
COLONEL THE CHEVALIER JAMES SHORTT
BARON OF CASTLESHORT
Borrmount Manor, Borrmount, Enniscorthy, Co Wexford     IRELAND

Separately, funds in Irish Punt (IR£) equalling US$50 may be transferred directly to the following account:

name: The Society of the Irish Brigade
account# 22299G
Enniscorthy Credit Union, Abbey Square, Enniscorthy, Co. Wexford, Ireland
tel +353-54-33835, fax -36613


For further information, please email the Commander at: Galloglas@hotmail.com

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