Membership of the Irish Sleep Society...

• The Irish Sleep Society (ISS) was founded on the 24th September 2005 following a meeting of healthcare professionals who specialise in disorders of sleep.

  Membership of the Society can be applied for by utilising forms that are available to download from this page.

  You will need either Microsoft^©®™ Word viewer or Adobe^©®™ Reader to download and print forms.

   

  ISS Membership Application Form 2012   Download Application Form in Word document (Preferred)     AIB Standing Order PDF Fill in Online & print   AIB Standing Order PDF Pre-filled Select & Print (Change Start date)   AIB Standing Order JPEG Image Select & Print (Change Start date)       Download Microsoft Word Viewer Adobe Reader Download - All versions

   

  

   

  APPLICATION FOR MEMBERSHIP 2012

   

                                      *IF NOT ATTENDING THE AGM*

   

  NAME : _______________________________________________________

   

  ADDRESS :  (Work):  ____________________________________________

   

  ______________________________________________________________

   

  Address for correspondence if different:  _____________________________

   

  ______________________________________________________________

   

  Profession/Discipline:__________________________________

   

  E-mail: ______________________________________________________

   

  Phone No: (Daytime): __________________________________

   

  Phone No (Mobile): ____________________________________

   

   

  Full Membership           �                      Student Membership     �

   

  (Please enclose payment of €20 for Full membership and €10 for Student)

   

  …………………………………………………………………………………………..

  OFFICE USE ONLY :

   

  Payment Method:  __________________

   

  Membership number: ___________________  Valid until: ______________

   

  Return to:  Sarah Keane

                   The Irish Sleep Society

                   P.O. Box 11850

                   Dublin 1

                    

  Cheque /postal order made payable to ISS accepted only

   

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