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Geographical area your group covers:




Facebook page:
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Alternate Contact First Name:
Alternate Contact Last Name:
Alternate Contact Phone:
Alternate Contact Mobile:
Alternate Contact Email:
Alternate Contact Position:
Select the Pilar:
Municipal District:
What is the main cause of your group:
Governed by rules or a constitution:
Date Established * :
Group's structure:
If other group structure, describe:
Aims:
Notes:
Number of paid staff in org:
Number of volunteers in org:
Number of other staff in org:
Number of members in org:
Is Membership open to everyone:
What will Tipperary PPN do with your information?

Groups joining Tipperary PPN are providing us with 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 Tipperary PPN’s secretariat, with the Environmental Pillar, with Tipperary County Council and with other bodies or persons who require access in order to facilitate the ongoing work of the PPN.

When you join Tipperary PPN you are also agreeing to receive emails and newsletters from us.

Tipperary PPN will not supply the information provided to it to any person or organisation not engaged in PPN work or activities or in the community and voluntary sector in Tipperary.

In the future Tipperary 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 30 days’ notice to Tipperary PPN

I consent for my data to be processed as described above (tick to consent) *:

For PPN membership, we look for your details and details of an alternate contact. Please only supply details of an alternate contact if you have permission to do so. Please tick the box below to confirm that you have their permission to supply their contact details.

Alternate Contact Permission:

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