Membership Application

An * indicates a required answer. This includes the boxes indicating your acceptance of our Privacy Policy and Membership Rules.

Applicant Details

First Name *

Surname *

Address *

Main Phone Number

Alternative Phone Number

Email *

Preferred Contact Method

Phone

Declaration *

I have the permission of the owner(s) to supply the above phone number(s) and email address

Supporting Information

If you know someone in a local Irish community organization (including the NIC) who can support your application, please give their details below.

Name

Organization

Contact (Email/Telephone)

Data Protection

Under the Data Protection Act 2018 and the General Data Protection Regulation (EU) 2016/679 (GDPR), we have a legal duty to protect any information we collect from you. We use appropriate measures to safeguard your details to prevent unauthorised access to it.

I have read, understood, and accepted the PRIVACY POLICY and I positively opt in to the holding/processing of my details, which may include marketing purposes. (By ticking this box you opt-in.)

Rules for Membership *

I have read, understood, and accepted the rules for membership.

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Membership Application

Applicant Details

Supporting Information

Data Protection

Supported by:

Copyright & Privacy