Cycling Ireland | New Club Application

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New Club Application

New Club Application

Club Name *

Location *

County *

Chair Name *

Chair Membership Number *

Chair Email *

Chair Contact Number *

Secretary Name *

Secretary Membership Number *

Secretary Email *

Secretary Contact Number *

Treasurer Name *

Treasurer Membership Number *

Member 4 name *

Member 4 Membership Number *

Member 5 name *

Member 5 Membership Number *

Member 6 name *

Member 6 Membership Number *

Type of Club (eg youth, leisure, racing etc) *

Reason(s) for setting up a new club *

Details Submitted By *

Your Email Address *

I confirm that the above details are, to the best of my knowledge, true *