IPBS Application For Membership
To apply for an individual membership in the Irish Protestant Benevolent Society of Montreal, please complete this application in it's entirety and submit. Thank you!
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Email *
Salutation *
First Name *
Last Name *
Street *
City *
Province/State *
Postal Code *
Mobile Phone *
Home Phone *
Business Name
Business Phone
Spouse (if applicable)
What is your Irish heritage?
Other connection(s) to the IPBS?
Thank you for interest to become a member of the Irish Protestant Benevolent Society of Montreal. The annual dues are $25.00, payment of which must be made at the time your application is conditionally approved and annually thereafter.

By checking this box I authorize this request for membership to the IPBS for the named individual on this form. *
---------------------- FOR IPBS INTERNAL USE -------------------------
Applicants, please do not enter anything in this section.
Proposer Name
Seconder Name
Date Conditionally Accepted
A copy of your responses will be emailed to the address you provided.
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