Renew Annual Subscription

Please fill out the renewal form before submitting your  subscription fee. If you do not send us the form, it may cause us difficulties to match payments to member details. If you have any issues with the form, please call us on 01 889 8920.

If you are a Life Member, or have already paid your membership for this year, you do not need to proceed.

If you are a Life Member, or have already paid your membership for this year, you do not need to proceed.

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Date joining

Thank you for renewing your membership of Polio Survivors Ireland and for continuing to support our work.


If you have any questions or concerns, or difficulties in filling out this form, please call our office at 01 889 89 20.


Receipts are not normally issued for annual membership payments but a certificate will be issued to life members.