JOIN THE PPN Who can join? Online Registration form for Clare Public Participation Network First Name: * Last Name: * Your Organisation Name: * Email: Website: Phone: Mobile: Area/Town: City/County: Eircode: Alternate Contact First Name: Alternate Contact Last Name: Alternate Contact Email: Alternate Contact Mobile: Alternate Contact Phone: Tell us more about your organisation: What Pillar does your group belong to?: * --None--CommunityEnvironmentSocial Inclusion What is your Municipal District: * --None--West ClareEnnisKillaloeShannon What is the main cause of your organisatoin: --None--Addictions and RecoveryAnimalsArts, Culture and MediaCarersChildrenCommunity CentreCommunity DevelopmentCrime/SafetyEducation/LiteracyEmergency and Ambulance ServicesEnvironment and ConservationFamilies/ParentingHealth/Hospitals/HospicesHeritage/Museums/GalleriesHomelessness/ HousingHuman and Civil Rights/EqualityIntellectual/Learning DisabilitiesLaw/Legal Support/JusticeLGBTMens GroupsMental HealthMinority GroupsOlder People/Active RetiredOverseas Aid/DevelopmentPhysical DisabilityPoliticsPrisoners/Offenders/Ex-offendersRefugees/Asylum SeekersReligion/Faith basedResidents AssociationSensory ImpairmentSocial InclusionSports/Outdoor activitiesUnemploymentVolunteering and Active CitizenshipWomens GroupsYouth Are you governed by Rules or a constitution: --None--YesNo What is your groups Group's structure?: --None--AffiliatedAssociationCharityCommitteeCo-operativeLimited CompanyOtherSet of RulesTrust If other, please describe your structure: Is Membership open to everyone?: --None--YesNo Number of members in org: Number of other staff in org: Number of paid staff in org: Number of volunteers in org: Data Protection:What will Clare PPN do with your information? Groups joining Clare PPN are providing their contact details in order to enable them to be fully consulted and included in the local democratic processes as well as in the national network of PPNs. Groups joining the PPN are entering an agreement that the details they supply may be shared with other members of the network, with the elected representatives of the PPN, with members of Clare PPN’s secretariat, with the Environmental Pillar, with Clare County Council and with other bodies or persons who require access in order to facilitate the ongoing work of the PPN. Clare PPN will not supply the information provided to it to any person or organisation not engaged in PPN work or activities. In the future Clare PPN may display the names and locations of member groups on its website. Individuals or member groups may request to have their personal data supplied to them and/or removed from or updated on the register by giving 14 days’ notice to email@example.com or by post to the address above. I agree to Data Protection Terms * Type the text shown: * Send me a copy * These fields are required. If you would prefer you to submit your registration form by post you can print it here and post it to the address below.