Membership Application/Renewal Form

Membership Renewal

I would like to renew my membership/become a member of the Offaly Historical & Archaeological Society for 2011.  Annual Subscription is €30.  This is due from December 13th, 2010 .

Name: _________________________________

Address: _______________________________________

____________________________________________________________________________________________

Email address: ________________________________

Credit Card No. ____________________________

Cardholders Name: _____________________________

Expiry Date: _________________________   

I enclose a cheque/cash/visa for €………….

Please call, post or email the completed form, together with your subscription to the OHAS Centre. (You may use the PayPal payment system, which can be found on the home page of www.offalyhistory.com or www.irishmidlandsancestry.com.)

For further details on membership please contact the Offaly Historical & Archaeological Society, Research Centre, Bury Quay, Tullamore, Co. Offaly.  Tel: 057 93 21421