The Irish Club Of Belgium

Membership Application


The annual cost for membership is as follows:

Family (30 euros)
Single (20 euros)
Student (10 euros)
Au-Pair (10 euros)
Stagiare (10 euros)

Payment must be sent to the Irish Club Bank Account 310-1486500-61.

Students/Au-Pairs/Stagiares must send proof of status by e-mail to membership@irishclub.be.

To proceed with membership application please complete the details below.

Your future login will use your email address and password you supply here.
Title :
Last name * :
First name * :
E-mail address * :
E-mail adres (backup) :
Telephone home :
Telephone office :
Fax :
Mobile :
Street * :
Nr * :     Box:
City * :
Postal code * :
Country :
Nationality :
Membership type * :
If family membership please include all family names in the remarks section below.
Remarks :
Password *:
Confirm password *:
Interests:
Art Bridge
Cultural Visits Golf
Hillwalking Music workshop
Other Poker
Quiz Satellite
Set Dancing Setanta Sponsor
Social Solo Dancing
Test Theatre
Walking Club
How did you hear about us :
What type of events do you think we should organise :
I agree to receive monthly newsletters by email
I agree to receive other Irish Club communications by email
I agree to receive mailshots from 3rd parties
* Mandatory fields