MEMBERSHIP APPLICATION FORM

ORGANISATION DETAILS

Organisation Name

Organisation Email Address

This email address will be displayed in the Members Directory on dlrppn.ie and should be your groups’ official email address, not a personal one, if you do not want a contact email address to be displayed for your organisation please leave this field blank.

Address

Area/Town

City/County

Eircode

Website

Facebook Page (if any)

Twitter address (if any)

Instagram Page (if any)

CONTACT DETAILS

First Name

Last Name

Mobile Phone

Phone

Role in Organisation

Please submit details of your alternate contact person below. Please tick the box to confirm you have permission to supply their information to us.

Permission Declaration

I have permission to submit the contact details below

Alternate Contact First Name

Alternate Contact Last Name

Alternate Contact Mobile

Alternate Contact Email

Alternate contact role in Organisation

ABOUT YOUR ORGANISATION

Tell us more about the work of your organisation

What is the main cause of your group

Date your group was established

This must be a dd/mm/yyyy

What Pillar is most appropriate for your organisation

In what electoral area are your activities mainly focused?

Is your group Governed by rules or a constitution

What is your groups structure

If other group structure, describe

Is Membership open to everyone

Number of members in org

Number of paid staff in org

Number of other staff in org

Number of volunteers in org

DOCUMENTS REQUIRED

In order for the Secretariat to review your group's application the following documents are required:

- A copy of your group’s Constitution.

- Minutes of one of the following

your most recent AGM
your most recent committee meeting

Your group's constitution

PDF, DOC, DOCX,PNG or JPEG format only please. Any other file types will result in a failure to submit this application

Minutes of your most recent AGM or most recent committee meeting

PDF, DOC, DOCX,PNG or JPEG format only please. Any other file types will result in a failure to submit this application

THE LEGAL STUFF

How will DLR PPN use your personal data?
Under the provisions of the Local Government (Reform) Act 2014 Dún Laoghaire-Rathdown Public Participation Network (DLR PPN) is the official link between the Local Authority and Community & Voluntary, Social Inclusion and Environmental groups within Dun Laoghaire-Rathdown. The remit of DLR PPN is to ensure that member groups have a voice in Local Authority decision-making, to build the capacity of DLR PPN member groups and to act as a hub for DLR PPN members to network, share and receive relevant information.

DLR PPN will use the information your group or organisation provides during registration to send you information about DLR PPN events, activities and training, information from Dún Laoghaire-Rathdown County Council that that we deem to be relevant to DLR PPN members, information about local and national consultations, our monthly e-newsletter and any other information we deem legitimate to carrying out our remit.

If you provide us with contact information for alternate contacts for your group or organisation, you agree that you have obtained the consent from the alternate contact for the disclosure and use of their personal data as described above. You can request a copy of your personal data or request that your personal data be updated or removed from our database by emailing secretariat@dlrppn.ie or by writing to the postal address below.

DLR PPN displays the organisation name, organisation contact details & location of member groups on its website in the Members Directory.

GDPR Consent

I agree to allow DLR PPN to store my group/organisation's contact details on a database held by DLR PPN and/or its agents for the purposes listed above.

Your Rights Under GDPR