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MEMBERSHIP APPLICATION
(Please print)
Full Name:
Spouse's/Children's Names(if Family Membership)
Home Address (Please include zip code)
Home telephone: ( ) Days ( ) Evenings
E-mail:
Place of birth:
Hobbies:
How did you find out about the society?
Please complete and send this portion to the address below.
Enclose a check made out to AICS for yearly membership dues.
Individual $25
Family $40
All-Ireland Cultural Society
P.O. Box 3411
Portland, OR 97208
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