INA Membership Application Form

All the information that you give on this form is confidential and will not be shared with anyone else. By giving us your e-mail address you are giving your consent to receive our monthly newsletter and other notifications. You can unsubscribe at any time.

Your Name *

If you are joining as a couple or a family please enter the name of the second adult here. Otherwise leave this section blank.

Address Line 1 *

Address Line 2 *

Address Line 3 *

Address Line 4

Eircode or Postcode

If you don't want any post to be issued to your address please write NO POST below. If you chose this option your membership pack will be issued by email.

Your date of birth *

YYYY

If you are joining as a couple or a family please enter the date of birth of the second adult here. Otherwise leave this section blank.

YYYY

Are you joining as a single person (male or female), a couple or a family? *

Single Male

Single Female

Couple

Family

Your gender: *

Male

Female

If you are joining as a couple or a family please enter the gender of the second adult here. Otherwise leave this section blank.

Male

Female

Clear selection

Your e-mail address:

If you would like newsletters and other notifications to be delivered to a second e-mail address please enter it here (optional):

Your mobile phone number: (Your phone number will not be shared and will be used only in very limited circumstances e.g. to advise you of the last minute cancellation of an event).

Names and dates of birth of family members under the age of 18 to be covered by membership

Were you previously a member of the Irish Naturist Association? *

Yes

How did you hear about the Irish Naturist Association? *

I confirm that I/we have paid the appropriate membership fee. *

Yes

Required

I acknowledge that my/our membership application will not be processed until I submit a head and shoulders photo or selfie of each adult by email to info@irishnaturism.org. (Photos of family members under 18 are not required) *

Yes

Required

I/We agree to be bound by the rules of the Irish Naturist Association - please see the membership page of our website for further information. *

Yes

Required

Date *

YYYY

For INA Office use:

Membership Number ________

Mailing List updated

Membership Secretary advised

Membership List updated

Database updated

Amount Paid € ______

Photo submitted

Payment method: Stripe /Cash /Cheque /PO

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