Inclusion Ireland - Membership Group Application Form




	FEE SCALE
	MEMBER ORGANISATIONS
	GROUP APPLICATION FORM
	INDIVIDUAL APPLICATION FORM


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Membership: Group Application Form

Please fill in the form below, or you can download it here and print it and post it back to us: Inclusion Ireland, Unit C2, The Steelworks, Foley St, Dublin 1.

Name or Organisation:
Address:
Telephone:
Fax:
Email(Username):
Password:
Note: Please choose a password so you can log into member only areas of the site and renew your membership online in the future.
Website:

Is your organisation primarily a (please tick):
	Service Provider:
	Professional Group:
	National Body:
	Parents & Friends Group:
	Other (please specify):

Type of Group:

Description of organisation and service provided:

Should your organisation be approved for membership at our next board meeting, we will require the name of a delegate for our records:
Delegate:
Address:
Telephone:
Mobile:
Email:


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

Inclusion Ireland, Unit C2, The Steelworks, Foley Street, Dublin 1, Ireland. Tel: 01 8559891 Fax: 01 8559904 Email: info@inclusionireland.ie