Ladies Ancient Order of Hibernians

Membership Application

To Apply for membership in LAOH, Division 8, Glen Cove, NY, please complete the following form and follow the directions at the end in order to electronically submit it for consideration:

Name:   

Address:   

City:        State:        Zip:   

Phone:   

Email:   

Are you a Roman Catholic?    Yes No     Name of Parish:   

Have you complied with your religious duties within the past twelve months?    Yes No

Please check qualifications for membership (choose all that apply):

    Irish by birth

    Irish by descent

    Wife of an AOH member

    Mother of an AOH member

    Mother of a Junior member, LAOH

Occupation:   

Business Address:   

Date of Birth:   

Were you ever a member of the LAOH?    Yes No

 If so, in what city, town and state?    Former  Division #:   

Cause of your withdrawal?   

Do you belong to any society to which the Catholic Church is opposed?    No Yes

Name of your sponsor:   

I heard of the organization through:   

In order for you application to be electronically submitted for consideration, please press the button below to pledge that the answers to the above questions are true, and then press "submit".