The Association of Irish Stage Technicians - Membership Application Form


Forename:
Surname:
E-Mail Address 1:
E-Mail Address 2:
Home Phone Number:
Mobile Phone Number:
Work Phone Number:

Home Address

Address 1:



Address 2:
Town:
County:
Postcode:


Job Title:


Main Job Are You...
Main Job Are you self employed?
Secondary Job Are You...
Secondary Job Are you self employed?

Name and Address of Employer

Name:



Address 1:
Address 2:
Town:
County:
Postcode:


Today's Date:


Finally, please give details of what you would like to see the AIST doing for you...

It is our intention to have a list of our current membership on our website. This will list no contact details and will only list your name Ò your job title Ò and where you work. Please check this box if you do NOT wish to be listed on the site.