This form is for new members of Inclusion Ireland. Existing members can renew online. Contact informationPlease enter your personal contact information here. Name * Address * Please enter your full postal address. Telephone Mobile Email * Enter your email address here. This is the address that your newsletters will be sent to. Additional information interest in intellectual disability Person with an intellectual disability Parent of a person with an intellectual disability Relative of a person with an intellectual disability Professional (please specify) Member of local association (please specify) Issues of particular interest to you (please tick) Early Intervention Education Respite Waiting Lists Staffing Issues Benefits & Allowances Rare Syndromes Challenging Behaviour Legal Issues Research Other How did you hear about Inclusion Ireland?