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County Select County Antrim Armagh Carlow Cavan Clare Cork Derry Donegal Down Dublin Fermanagh Galway Kerry Kildare Kilkenny Laois Leitrim Limerick Longford Louth Mayo Meath Monaghan Offaly Roscommon Sligo Tipperary Tyrone Waterford Westmeath Wexford Wicklow

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When you ceased working at Trinity, which Department were you employeed in?

Retirement date (Month/Year) Select Month January Februrary March April May June July August September October November December Select Year 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

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I confirm that I have read the Notes relating to membership and the privacy policy. If admitted as I member, I agree to be bound by the Constitution of the Trinity Retirement Association

Important Notes:

• Prospective members should review the current Constitution of the Trinity Retirement Association prior to submitting a membership application form.
• Members acknowledge that the Association operates on a self-governing and self-financing basis and holds no representational rights with the University of Dublin, Trinity College.
• For Association-affiliated member events held on campus, members acknowledge and accept that they must at all times adhere to College Health & Safety Policies. General meetings on Campus premises will be covered under the College’s Public Liability Insurance Policy in a manner analogous to that for affiliated extramural activities undertaken on campus.
• For Association-affiliated member events held off campus, members acknowledge and accept that the Association does not hold insurance cover for members participating in such events, nor for travel to/from such events, and that the Association and its Officers have absolutely no liability in this regard.
• Members acknowledge that the annual membership fee falls due on 1st January each year. (Please note that for those retiring in September of any year, they are not required to pay the annual membership fee until 1st January following their retirement.)