Name : ___________________________________________________________________

Address: __________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Email: ___________________________________________________________________

Tel: _____________________________________________________________________

Signature(s): ______________________________________________________________

How long have you owned Irish Terriers ? _______________________________________

How many do you have? _____________________________________________________

From whom did you purchase your first Irish Terrier _______________________________

Single Membership € 5, Joint Membership € 7 and Family Membership € 10

Proposed By: ______________________________________________________________

Seconded By: ______________________________________________________________

Please forward completed application to the Secretary. Your application will be put to the
Committee at our next meeting and you will be notified. Thank you for your interest in the
All Ireland Irish Terrier Club.
If we can help you in any way please do not hesitate to contact us.

Fionnuala Malone
Glenfitor
265 St James Road
Greenhills
Dublin 12

www.irishterrierclub.ie