Membership Renewal: Group Payment Details

Please note, this form is for organisations who are EXISTING Members of Inclusion Ireland. New organisation members can join online.

Organisation information
Please enter your full postal address.
(If you ONLY use a mobile phone then please enter it in the 'Telephone' field)
Delegate information
Should your organisation be approved for membership at our next board meeting, we will require the name of a delegate for our records.

A delegate is appointed by the organisation, as a representative to attend Inclusion Ireland General Meetings and to vote at meetings. The delegate receives all Inclusion Ireland correspondence and is responsible for passing it on to the organisation. Please enclose a copy of your organisation’s Constitution with the application. Please note once your application has been approved the affiliation fee will be due. To determine what fee your organisation will have to pay please look at our Fee scale by clicking here: Fee Scale  XXXX {document contains different fees than online version and need to be revised as such}

(If you ONLY use a mobile phone then please enter it in the 'Telephone' field)
Please enter your full postal address.
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.