Sunday, July 7

The New Barleycorn

Sunday, July 14

Club Family Picnic

Sunday, August 11th

Annual Steak Roast with
The New Barleycorn

Sunday, August 18th

Irish Bluegrass Country Festival

Sunday, September 15

Clam Bake

Sunday, July 7

The New Barleycorn

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Club Membership

West Side Irish American Club Membership

Please fill out one Order Detail Form and submit per each adult membership with your order.

NOTE:
Each adult member has a unique membership number. If renewing, please fill out the number in the space provided. If new member, please leave the membership number space blank.

If your child turned 18 in 2012, please fill out an adult membership for that child. If your child turns 18 in 2013, you may include the child in your membership.

Order Details:
Renewal:
Membership Number :
Membership Type:
Title:
First Name :
Last Name :
Date of Birth :	(format: yyyy-mm-dd)
Street Address :
Apartment # :
City :
State :
Zip :
Phone :
Cell :
Email :
Children Under 18
Number of Children Under 18:	Enter Names & Birthdates Below
Child One Name :
Child One D.O.B. :	(format: yyyy-mm-dd)
Child Two Name :
Child Two D.O.B. :
Child Three Name :
Child Three D.O.B. :
Child Four Name :
Child Four D.O.B. :
Child Five Name :
Child Five D.O.B. :
Child Six Name :
Child Six D.O.B. :
Volunteer: Check Areas of Interest
Tuesday Morning Maintenance :
Tuesday Night Cleaning :
Bartending :
Fish Fry :
Library :
Gardening :
Order Membership(s)
General Membership:	(18 years of age and older)
Forever Young Membership:	(50 yrs. of age and over, must be a WSIA member to join)

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Sunday, July 7

Sunday, July 14

Sunday, August 11th

Sunday, August 18th

Sunday, September 15

Sunday, July 7

Club Membership