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MEMBERSHIP APPLICATION FORM

I would like to join THE IRISH ASSOCIATION OF OLDER PEOPLE
and I enclose the annual membership fee of 10 euro.

YOUR NAME (BLOCK LETTERS)

ADDRESS

PHONE NUMBER

EMAIL ADDRESS

DATE

SIGNATURE

Please complete and post,
along with a cheque in the amount of 10 euro, to:

The Irish Association of Older People
4 Sussex Street
Dun Laoghaire
Co. Dublin