Celtic Fringe Membership Application

To apply for membership, print this page and mail with a check or money order to the address at the bottom of the page.
Name:
Other Family Members:
Address:
City, State, Zip:
Phone:
E-Mail:
Single: $25.00		Family: $30.00
(Make Checks Payable to the Celtic Fringe)
Renewal:		New Membership:
Amount Enclosed:		Date:
I wish to donate an additional $________ to the Special Needs Fund.
The Celtic Fringe meets on the first Tuesday of each month at 7:30pm at Charlie Hooper's Bar and Grill on 63rd Street in Brookside. Please visit our website at: www.celticfringe.org for more information. Mail to: Jayme Wear PO Box 23803 Stanley, KS 66283 Tel: (913) 469-0810 go raibh maith agat! (thank you very much)