Founded 1737
Application for Membership
Name ________________________________________________________
Residence ________________________________________________________
Address ________________________________________________________
Phone ( ) __________ Fax ( )___________ e-mail _________________
Business _________________________________________________________
Address _________________________________________________________
Phone ( ) __________ Fax ( )___________ e-mail _________________
Preferred Mailing Address [ ] Residence [ ] Business
Occupation _____________________________________________
I hereby apply for membership in THE CHARITABLE IRISH SOCIETY
Applicant’s Signature _______________________________ Date ________
Sponsored by ____________________________________
Please forward this application with a check for $50.00 to
Charitable Irish Society
John J. Burns Library
Boston College
140 Commonwealth Ave
Chestnut Hill, MA 02467-3801