INA Membership Application Form

Please complete all sections of this form and enclose TWO PASSPORT SIZED PHOTOGRAPHS of each adult.
Fields "Address 1", "Address 2", "Address 3" signify home address.


Please tick :      Single: 		Family 	    Couple 

Full Name : _________________		Full Name : _________________
Address 1 : _________________		Address 1 : _________________
Address 2 : _________________		Address 2 : _________________
Address 3 : _________________		Address 3 : _________________
Phone : ______  _____________		Phone : ______  _____________
Gender : M/F  DOB __/__/_____		Gender : M/F  DOB __/__/_____
Correspondance Address (if different): ______________________________
 ________________________________ e-mail(if any): ___________________
Family members under 18 to be covered by membership :
Names :   |_________| |_________| |_________| |_________| |_________|
D(S).O.B.: |_________| |_________| |_________| |_________| |_________|

How did you hear about the INA? _____________________________________
_____________________________________________________________________

I / We agree to be bound by the rules of the INA and enclose cheque/ postal order for €55.00 / €40.00 (if over 65 years) as appropriate along with two passport sized photographs of each adult.
Would you like your name(s)to be forwarded to the local INA representative in your area?: YES/NO


SIGNATURE 1:________________SIGNATURE 2:_______________Date :________

NATURISM (Nudism) is a way of life in harmony with nature characterised by the practice of communal nudity, with the intention of encouraging self respect, respect for the others and for the environment.
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Fee: €55 paid ___ €40 paid ___ (over 65) INF cards issued___ Memb No:I____