Add a Membership Registrar – Dysert O`Dea Clan

This page enables you, as an authorised user, to create a profile for a Membership Registrar and present it on the Membership Registrars page: Membership Registrars
A head-and-shoulders photo of each person is highly desirable.
Once you have prepared the photo, please complete the form below.
If you need help, please contact the Webmaster:

Data items marked with an asterisk (*) are required.
Name * REQUIRED
Job Role * REQUIRED
- Membership Registrar – Australasia and the Far East
- Membership Registrar – Ireland and the rest of Europe
- Membership Registrar – USA and Canada
- Membership Registrar – Rest of the World
Clan Email Address * REQUIRED
Personal Email Address (Optional)
Phone Number (Optional)
Postal Address (Optional)
Photo
Drop files here or

Accepted file types: jpg, jpeg, gif, png, Max. file size: 10 MB, Max. files: 1.
The recommended photo size is 200 pixels wide and 300 pixels high. The filetype can be jpg, jpeg, gif, or png. The maximum file size is 10 MB.
Maximum file size - 10 mega bytes.
Biographical Information (Optional)
Hidden
OFFICE USE ONLY
Name
This field is for validation purposes and should be left unchanged.

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OFFICE USE ONLY