Group Membership Application Form

Down Armagh Rural Transport Partnership
Group Membership Application

Down Armagh Rural Transport Partnership is fully committed to meeting its obligations on the promotion of equality and good relations as set out in Section 75 of the Northern Ireland Act 1998.For this reason, we need to know certain details about the users of our services.This information will NOT be used outside Down Armagh Rural Transport Partnership to identify you personally. Statistical type data will be forwarded to the Department for Infrastructure and other funders, when requested.
Name of Organisation*
Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Phone Number*
eg. 07712345678
Email*
example@example.com
Name & Contact Number of person we can contact in an emergency:*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Name & Address to which invoices should be sent (if different to above)

First NameLast Name
Address

Street Address

Street Address Line 2

CityCounty

Post Code
Phone Number
Please enter a valid phone number.
Email
example@example.com

INSURANCES - please confirm that your group has all necessary insurances in place including Public Liability and can produce proof if required (this is a condition of membership)*

YesNo
Please indicate the name of your insurance company *

Our organisation agrees to abide by the terms and conditions as set out in the Down Armagh Rural Transport Partnership Transport Policy, and we understand that any breach of these conditions may result in our group being expelled from membership. We understand that Down Armagh Rural Transport Partnership is registered under the relevant Data Protection legisaltion of the time and we consent to Down Armagh Rural Transport Partnership holding the above information about our organisation. We understand that this information will NOT be used outside Down Armagh Rural Transport Partnership to identify individual members but that statistical type data may be forwarded to the The National Lottery Community Fund and other funders, for future research purposes.
Signature*

Clear
Name of person completing the form

First NameLast Name
Position within the organisation
Should be Empty:

Down Armagh Rural Transport Partnership