Wicklow Triple A Alliance Membership form 2022/23
Welcome to Wicklow Triple A Alliance. We are a registered charity (RCN 20069254, CHY 18175) who support families in the Wicklow area who are affected by autism and cooccurring conditions. By completing this form you are consenting to Wicklow Triple A Alliance to contacting you. Membership is €30 per family per year if in work, an €10 per family per year if at home caring) Payment can be made via Paypal or Bank Transfer. (details at the bottom of this form).
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Email *
What is the name of your child/children? *
Would you like to add a second email address to the mailing list? (Please add another email if the email used is different to the email assigned to your Paypal account) *
How old is your child/children? (please tick all that apply) *
What activities or events would you like to see happening this year? *
Would you like to Volunteer with Triple A? Volunteering consists of helping out at events from time to time, running events (with the support of the committee) which you would like to see happen, and representing Triple A at some committees and working groups as and when they arise. *
Is there anything you would like to add?
Payment - Please pay the amount relevant to your family. Once you have sent payment, please email us at wicklowtripleamemberships@gmail.com to ensure you are added to our Facebook Private Members Group. To request access to the Private Members Group click here: https://www.facebook.com/groups/357884901306947  *
A copy of your responses will be emailed to the address you provided.
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