Wheeling Celtic Society

Membership Application

   Name: ______________________________________________

   Address: _____________________________________________

   _____________________________________________________

   City: __________________________ State: _______ Zip: _______

   Birthdate (optional): _________________

   Occupation: (optional): _____________________________________

   Individual Memberships are $25.00/year.

   Family Memberships are $35.00/year.

   Please print this application and mail along with your check or money order made
   payable to "Wheeling Celtic Society" to:

   Wheeling Celtic Society

   P. O. Box 2273

   Wheeling, WV 26003

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