U N I T E D  A R T S   C L U B
3 UPPER FITZWILLIAM STREET, DUBLIN 2, TEL: OFFICE: (01) 66 11 411, BAR: (01) 67 62 965, FAX: (01) 67 69 65
M E M B E R S H I P  A P P L I C A T I O N  F O R M
 
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BLOCK CAPITALS PLEASE:

1. FULL NAME OF CANDIDATE ................................................................................................
2. CANDIDATES RESIDENTIAL ADDRESS.................................................................................
.........................................................................................................................................,,,,...
3.CANDIDATES TELEPHONE NUMBER: ...............................................................,,,,................
4.PROFESSION/OCCUPATION .................................................................................................
5.OTHER CLUBS OF WHICH CANDIDATE IS A MEMBER:..........................................................
................................................................................................................................................
6.NAME OF PROPOSER: ........................................................................................................
7.NAME OF SECONDER: .........................................................................................................
TYPE OF MEMBERSHIP:
TOWN TOWN HOUSEHOLD COUNTRY COUNTRY HOUSEHOLD
OVERSEAS OVERSEAS HOUSEHOLD ARTIST ARTIST HOUSEHOLD STUDENT

APPLICATION FOR MEMBERSHIP:
I Hereby apply for ....................... membership of the United Arts Club Dublin Limited, subject to the Memorandum and Articles of association of the Club and I enclose a remittance of € ....... in respect of the subscription to the end of thecurrent calendar year.

Signature ............................................................ Date ...................................................

DECLARATION BY PROPOSER:
I hereby declare that the above named Candidate .......................................... has been known to me for ........... years and is, in my opinion, a fit and proper person for admission to membership of the United Arts Club Dublin limited.

Signature of Proposer .........................................  Date ......................................................

DECLARATION BY SECONDER:
I hereby second the nomination of the above named candidate for admission to membership of the United Arts Club Dublin limited.

Signature .........................................................  Date ...........................................................

NOTES TO PROPOSERS:

  1. This form duly completed and signed should be lodged with the Honorary Secretary together with: A. Relevant Subscription & Entrance Fee B.
  2. Letter of Recommendation from Proposer.. Remittance accompanying this form will be lodged upon receipt. In the event of the Candidate not being elected to membership the amount will be refunded.
  3. Persns resident within a 25 mile radius of the Club premises are eligible for admission as Town Members. Only Persons permanently outside that radius are eligible as Country Members.
Back to Membership Nominaitons will not be considered unless accompanied by the appropriate subscription, entrance fee and a letter from the Proposer.