Renew Membership – Polio Survivors Ireland

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.

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Street Address Address Line 2 County / State / Region Eircode / Postcode Country

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I am paying my yearly subscription of €10

I am paying Life Membership

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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.

Renew Annual Subscription

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