| Section One
- Group Details. |
| Group Name |
|
| Group Address |
|
| Phone Number |
|
| |
|
| Email Address |
|
| Website Address |
|
| |
| Would like your website to have
a hyperlink with Galway City Community Forum ?
|
|
| Date/Year of Establishment |
|
| Number of Members |
|
| Is your group open to new members?
|
|
Do you have? |
|
(a) Regular Meetings?
Yes/No If yes, How often? |
|
| (b) Written minutes/records etc..?
|
|
| A written constitution or statement
of aims/objectives? |
|
| A bank account |
|
| |
|
|
| Names of Officers: |
|
| Chairperson |
|
| Secretary |
|
| Treasurer |
|
| From which, any or all of the
following do you receive financial assistance from? (Please
Tick Boxes) |
| Statutory Grant Aid |
|
| Fundraising |
|
| Membership Subscriptions |
|
| Galway City Council |
|
| Galway City Partnership |
|
Department of Social,
Community & Family Affairs |
|
| FÁS |
|
| County & City Enterprise Board |
|
| Western Health Board |
|
| Other |
|
| Purpose and Aims of your Group
|
|
| Section Two
- Facilities and Skills Base |
| 1) Does your group own facilities?
(e.g. rooms for meetings, sports facilities, (Please tick
box) computer facilities If no, go to question 2) |
|
| If yes, specify type of facility |
|
| Where is the location of the facility
(e.g Renmore) |
|
| Are such facilities available
on a rental/hire basis to other organisations? |
|
| 2) Do you have any skills/resources
you would like to share with other organisations? |
|
| If yes, please specify type of
skill/resource (Please tick box or boxes) |
| Facilitation Skills
|
|
Enterprise Skills |
|
| Working with Youth |
|
Local Development Skills |
|
| Childcare expertise
|
|
Training of Trainers |
|
| PR Skills |
|
Business Experience |
|
| Working with Older People |
|
Legal Skills |
|
| Accountancy |
|
Computer/IT/Web Design |
|
| Others (Please specify) |
|
| Section Three - Areas of Interest |
Often, when members of the Community
Forum are acting as representatives to other bodies, it is
done on a cluster basis.
IMPORTANT!
When members of the Community Forum are acting as representatives
to other bodies, it is done on a Cluster basis. Please tick
ONLY ONE box from EITHER Cluster A OR
Cluster B. |
| Cluster A |
|
CLUSTER B |
|
| Community |
|
Environment |
|
| Voluntary |
|
Conservation |
|
| Disadvantaged |
|
Culture |
|
| |
|
|
|
| |
|
| |
| Community |
|
Environment |
|
| Anti-Disadvantage |
|
Culture |
|
| Sport |
|
Recreation |
|
| Resident’s Association |
|
Youth |
|
| Heritage |
|
Enterprise |
|
| Other (Please specify) |
|
|
|
| |
|
|
|
| 1) Galway City Community facilitates
Galway City Intercultural Forum, a platform for groups working
to promote an intercultural Galway - Please
indicate below if you wish to register with the Intercultural
Forum |
|
| Yes |
|
No |
|
|
| |
|
|
|
| 2) Galway City Community facilitates
Galway City Sports Forum, a platform for Sports Clubs and
groups working to promote physical activity - Please
indicate below if you wish to register with the Sports Forum |
| Yes |
|
No |
|
|
| If you ticked yes, which of the
following is the main area for your group/Club? |
| Indoor Sports |
|
|
|
| Outdoor Sports |
|
|
| Water Sports |
|
|
| Section Four
- Contact Details |
| Do you wish to join The Galway
City Community Forum? |
|
| Person to whom correspondence
is to be sent: |
| Name |
|
| Address |
|
| Telephone Number |
|
| Email Address |
|
| |
|
Upon signing the Galway City Community
Forum Registration Form you are taking responsibility that
all telephone/fax numbers, names addresses etc. are correct.
The details given here in relation to your group may be used
for Community Information, Directories, websites etc. If you
do not wish to have your contact details published, please
tick the No option. No
|
Signed:
(Member on behalf of group) |
|
Please return the completed registration
form to: -
Poul Walsh Olesen,
Community Forum Co-ordinator,
Galway City Council,
College Road,
Galway. |
|
| Telephone Number: 091 - 536 458
|
|
| |
|
|
|
|
|
| |
|
