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!
Email address *
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. *
Required
---------------------- FOR IPBS INTERNAL USE -------------------------
Applicants, please do not enter anything in this section.
Proposer Name
Seconder Name
Date Conditionally Accepted
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A copy of your responses will be emailed to the address you provided.
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