IRISH ASSOCIATION FOR GIFTED CHILDREN.
An Óige Thréithnach
FAMILY MEMBERSHIP FORM
CONFIDENTIAL
NAME OF PARENT(S) or GUARDIAN(S):_________________________________________________DATE_____________
Address: ___________________________________________________________________________
___________________________________________________________________________
Telephone: (Home) ____________________________________(Daytime) __________________________
Email address____________________________________________________________________________
How did you hear of the Association?____________________________________________________________________
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Full Names of children |
D.O.B. |
Been assessed? (Y/N) |
Where do they attend school? |
Comments. |
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I agree/ do not agree to have my name, address and telephone number being included on a membership list circulated to members.
Signed __________________________________________
Please return with £20 subscription to
Irish Association for Gifted Children (IAGC)
An Óige Thréitheach (AOT)
Carmichael House
4 North Brunswick Street
Dublin 7
Contact Telephone: (01) 873 5702