APPLICATION FOR MEMBERSHIP

PLEASE PRINT OR FILL THIS FORM OUT AND EMAIL TO SHELAGHMC@JUNO.COM

INCLUDE THE WORDS LAOH MEMBERSHIP APP IN SUBJECT LINE

DATE:________________________

NAME___________________________________________________

ADDRESS________________________________________________

CITY________________________STATE_______ ZIP____________

PHONE______________________EMAIL_______________________

ARE YOU A ROMAN CATHOLIC?______________________________

HAVE YOU COMPLIED WITH YOUR RELIGIOUS DUTIES WITHIN THE

PAST 12 MONTHS?________________________________________

PLEASE CHECK QUALIFICATIONS FOR MEMBERSHIP

___IRISH BY BIRTH___IRISH BY DESCENT___WIFE OF AN AOH MEMBER           

____MOTHER OF AN AOH MEMBER____MOTHER OF A JUNIOR MEMBER, LAOH

PARISH:___________________________________

OCCUPATION:______________________________

BUSINESS ADDRESS:____________________________________________________________

DATE OF BIRTH:____________________________

WERE YOU EVER A MEMBER OF THE LAOH AND IF SO, IN WHAT CITY/TOWN AND STATE?

___________________________________________________________________

WHAT WAS THE NUMBER OF YOUR DIVISION?_____________

WHAT WAS THE CAUSE OF YOUR WITHDRAWAL?_________________________

______________________________________________________________________________

DO YOU BELONG TO ANY SOCIETY WHICH THE CATHOLIC CHURCH IS OPPOSED?____________

SPONSOR:______________________________

I HEARD ABOUT THIS ORGANIZATION THROUGH:__________________________________

I PLEDGE THAT THE ANSWERES TO THE QUESTIONS ARE TRUE:

                                                 _________________________________________________

                      (SIGNATURE OF APPLICANT)