Registration Page

Name of Organisation: ^*

Address: ^*

Address Line 2:

City/County: ^*

Eircode:

Pillar that most closely represents your organisational aim: ^*

Municipal District your organisation is a member of: ^*

Cause that mostly represents the work of your organisation: ^*

Description/Aims: ^*

Date Organisation was established:

Group's structure: ^*

If 'Other' group structure, please describe:

No. of paid staff in Organisation:

No. of volunteers in Organisation :

No. of staff on a scheme:

No. of members in Organisation:

Is membership open to everyone: ^*

Website:

Facebook page:

Twitter page:

Role in Organisation:

I consent to you retaining my details below ^*

First Name: ^*

Last Name: ^*

Phone:

Mobile:

Email: ^*

I have Permission to Submit the Alternative Contact Details Below ^*

Alternate Contact Position:

Alternate Contact First Name:

Alternate Contact Last Name:

Alternate Contact Phone:

Alternate Contact Mobile:

Alternate Contact Email:

Send me a copy of this form at my email address

^* These fields are required.

* Under the Data Protection Acts 1988 to 2018, Government Departments, Offices and Agencies, as data controllers, have a legal responsibility to:

obtain and process personal data fairly;
keep it only for one or more specified and explicit lawful purposes;
process it only in ways compatible with the purposes for which it was given initially;
keep personal data safe and secure;
keep data accurate, complete and up-to-date;
ensure that it is adequate, relevant and not excessive;
retain it no longer than is necessary for the specified purpose or purposes; and,
provide a copy of his/her personal data to any individual, on request