APPLICATION ACTIVE MEMBERSHIP SOCIETY OF THE FRIENDLY SONS OF by fyl43660

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									                                                                                          APPLICATION
                                                                                                                 -For-

                                                                        ACTIVE MEMBERSHIP
                                                                                                             IN THE
          SOCIETY OF THE FRIENDLY SONS OF ST. PATRICK
                                                                               IN THE CITY OF NEW-YORK
                                                                                                                 1784




Secretary                                                                                                                                                        80 Wall Street, N.Y. 10005
RAYMOND C. TEATUM                                                                                                                                                                Suite 712


                New York                        20
                I hereby apply for Active Membership in the
                SOCIETY OF THE FRIENDLY SONS OF ST. PATRICK IN THE CITY OF NEW-YORK.

......................................................................................................................................................................................................................................


Full Name                                       ____________________________________________________________________
(Print)                                                                         FIRST                                           MIDDLE                                                          LAST


Residence Address                               ____________________________________________________________________

Business Address                                ____________________________________________________________________

Occupation or Profession __________________________________________________________________

Telephone Number                               ____________________________________________________________________

Email Address                                   ____________________________________________________________________

Place of Birth                                 ____________________________________________________________________

Date of Birth                                   ____________________________________________________________________

Citizen of the U.S.A. ____________________________________________________________________

Son or Grandson of Member _______________________________________________________________

Name of Father                                 ____________________________________________________________________

Place of Birth                                 ____________________________________________________________________
                                     APPLICATION-For-ACTIVE MEMBERSHIP IN THE
                                SOCIETY OF THE FRIENDLY SONS OF ST. PATRICK - { cont. }



Mother’s Maiden Name ___________________________________________________________________

Place of Birth                                 ____________________________________________________________________

What members of the Admissions Committee do you know?
______________________________________________________________________________________
______________________________________________________________________________________

To what organizations do you belong?
_______________________________________________________________________________________
______________________________________________________________________________________

State details of Irish ancestry                                 _______________________________________________________________
_______________________________________________________________________________________
______________________________________________________________________________________

Name of Irish ancestors                                         _______________________________________________________________
_______________________________________________________________________________________
______________________________________________________________________________________

Places of birth                                _____________________________________________________________________
_______________________________________________________________________________________
______________________________________________________________________________________

Proposed by                                     ____________________________________________________________________

Seconded by                                     ____________________________________________________________________

                                                                            Additional biographical facts

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________


                                                                                              Signature of Applicant _____________________________________

......................................................................................................................................................................................................................................

         Secretary’s Record:                                                      I      Elected 20                         I       Qualified 20                           I     Failed to qualify

								
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