Application for Membership
in the Clan Irwin Association

Contact Information
Geneology
Yes No
Membership Level
Annual Dues - $20.00
3 Yr. Member - $50.00
Lifetime Member - $400.00
Senior Life Member (55+) - $250.00

Please print this page and mail with your dues (in U.S. funds)
Make checks payable to Clan Irwin Association

Chairman, Clan Irwin Association
226 1750th Avenue
Mt. Pulaski, IL 62548-6635

For more information:
Phone: (217) 792-5226
Email: guyirvin@frontiernet.net