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APPLICATION FOR MEMBERSHIP
Please send this form to:-
The Treasurer,
Ulster Place-Name Society
Celtic Studies
School of Modern Languages
The Queen's University of Belfast
Belfast BT7 1NN
Tel: 028 9027 3689 Fax: 028 9033 5298
Please process this application for membership of the above Society for the year ending....................... .I /We enclose cheque for £10.00 /€16.00 (please delete as appropriate) being the subscription due.
Please make cheques payable to Ulster Place-Name Society.
Mr/ Mrs/ Miss/ Ms/ Dr/ Prof...............Name.............................................................................................................
Address.................................................................................................................................................................
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Post /Zip Code.....................................................
Signature...................................................................................................Date...................................................
