MEMBERSHIP  APPLICATION  FORM

(BLOCK CAPITALS)

   NAME_________________________________________    REG. NUMBER __________________

ADDRESS________________________________

                  ________________________________

                 _________________________________

STATION   __________________________ COUNTY ___________________  

CONTACT TELEPHONE NUMBER  (H) _______________________ (M)_______________________.

E-MAIL ADDRESS  ______________________________________

TYPE OF MEMBERSHIP :  Individual/Family  (delete whichever is inapplicable)   

DO YOU OWN A MOTORCYCLE  _____________.

IF YES, YOU MAY STATE MAKE & MODEL  __________________________________________

Please print and complete this Application Form and forward it, together with the relevant Garda Credit Union Forms, duly completed, signed and dated, to the Enrolment Officer,

Dave Mc Guigan,

Garda Station,

Lifford,

Co. Donegal.

I agree to be bound by the Constitution and Rules of The International Police Association Garda Motorcycle Club.

(copy of the Constitution and Rules are available on the website)

SIGNED _____________________________________                       DATE  ____________________

FOR OFFICE USE ONLY

Date Received___________________

          St. Raphael’s Garda Credit Union Standing Order Form

The Manager

St Raphael’s Garda Credit Union

1/2 Fox & Geese,

Naas Road,,

Dublin 22..

Dear Sir

             Please debit my Credit union account in accordance with the following instructions.

To: IPA Garda Motorcycle Club Current account,

Ulster Bank

 Buncrana.

 Co. Donegal

A/C Number 66317030

Sort code 98 – 53 - 85

Amount Payable  ……… € 30.00  or whatever amount is prescribed by the Garda Motorcycle Club as being the annual membership fee due.

First payment due …………on the 1^st January 20____.

Final Payment due…………until further notified in writing by me.

My Account Number is ________________________

Signature ______________________                 Date__________________

FOR OFFICE USE ONLY

Date Received___________________

          St. Paul’s Garda Credit Union Standing Order Form

The Manager

St Paul’s Garda Credit Union

Boreenmanna Road,

Cork.

Dear Sir

             Please debit my Credit union account in accordance with the following instructions.

To: IPA Garda Motorcycle Club Current account,

Ulster Bank

 Buncrana.

 Co. Donegal

A/C Number 66317030

Sort code 98 - 53 - 85

Amount payable   € 30.00    or whatever amount is prescribed by the Garda Motorcycle Club as being the annual membership fee due to the Club.

First payment due …………on the 1^st January 20____.

Final Payment due…………until further notified in writing by me.

My Account Number is ________________________

Signature ______________________                 Date__________________