Application Form
AIB Retired Staff Association (‘AIBRSA’)
Membership of AIBRSA membership is open to anyone in the
Republic of Ireland who is receiving a pension from AIB Bank.

Personal Data collected will be maintained in accordance with the
Data Protection Acts 1988 and 2003
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Title *
First Name *
Surname *
Postal Address *
Last Branch/Department *
Pension (Staff) Number *
Email Address *
Home Telephone
Mobile Number
Are you a member of IBOA / SIPTU *
The chosen method for paying annual subscriptions is by standing order
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