Title: Ulster Place-Name Society

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APPLICATION FOR MEMBERSHIP

Please send this form to:-

Dr Dónall A Mac Dónaill

Treasurer, Ulster Place-Name Society

c/o School of Chemistry

Trinity College

Dublin

 or

 Professor Mícheál Ó Mainnín

Chairman, Ulster Place-Name Society

School of Arts, English and Languages

10 University Square

Queen’s University of Belfast

Belfast BT7 1NN

 

Please process this application for membership of the above Society for the year ending....................... The rate for individual members is £10/€14. I/we enclose cheque for £10.00  /€14.00 (please delete as appropriate)  being the subscription due. 

Please make cheques payable to Ulster Place-Name Society.

Mr/ Mrs/ Miss/ Ms/ Dr/ Prof...............Name.............................................................................................................     

Address.................................................................................................................................................................

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Post /Zip Code.....................................................

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