Membership Form

Harp & Shamrock Society of TexasApplication for Membership
Your Name *

First Name Last Name
Spouse's Name

First Name Last Name
Names of Child(ren) and their age(s)
Please separate each child with a comma (,)

Address *

Home Phone (Landline)

Area Code Phone Number
My Cell Phone

Area Code Phone Number
Spouse's Cell Phone

Area Code Phone Number
May we send you text messages?

Yes!
E-mail address *
May we include your email address in our member directory?

Yes!
Please briefly describe your Irish background, if known. *
Your Irish Background (please type n/a if not known)
Type of Membership *

Individual Annual Membership ( $ 20.00 )

Family Annual Membership ( $ 35.00 )

Benefactor Annual Membership ( $ 200.00 )

Patron Annual Membership ( $ 500.00 )

Lifetime Membership ( $ 1,000.00 )

Total $ 0.00
Should be Empty:

Harp & Shamrock Society of TexasApplication for Membership