Please print and complete this form and send
along with your check made payable to:
$25.00/family and
$15.00/single membership
... and are due when you join the Club.
IACS,
P.O. Box 530142
Debary, FL 32753
Become a Leprechaun Booster
You can support our newsletter by becoming a Leprechaun Booster. Contributions of $10.00 are due for 2006. If you are not a booster, please give the IACS a little extra support. The booster money is a big help in paying for the Leprechaun newsletter expenses. These can be paid to our Treasurer at any meeting or sent to the club as mentioned above.
Type of Membership: Please Check One
Family
Individual $15
Add'l Leprechaun Booster Support
$10
Total Amount Inclosed:
Name
Phone
Email:
Complete Address w/City, State, Zip
Ancestral
Irish County: (if known)
Interests
and Hobbies:
Family
Information (Spouse, children, etc.):
Please check any of the following committees
that interest you. Please note, openings may not be available.