| Section One - Group Details. |
| Group Name |
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| Group Address |
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| Phone Number |
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| Fax Number |
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| Email Address |
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| Website Address (if any) |
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| If you have a website
or plan on doing so in the future, would you be interested in having
a hyperlink with Galway City Council website?
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| Date/Year of Establishment |
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| Number of Members |
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| Is your group open to new members? |
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Do you have? |
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(a) Regular Meetings? Yes/No If
yes, How often? |
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| (b) Written minutes/records etc..? |
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| A written constitution or statement of aims/objectives? |
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| A bank account |
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| When did you hold your most recent AGM? |
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| Names of Officers: |
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| Chairperson |
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| Secretary |
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| Treasurer |
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| From which, any or all of the following
do you receive financial assistance from? |
| Statutory Grant Aid |
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| Fundraising |
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| Membership Subscriptions |
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| Galway City Council |
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| Galway City Partnership |
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Department of Social,
Community & Family Affairs |
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| FÁS |
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| County & City Enterprise Board |
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| Western Health Board |
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| Other |
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| Purpose and Aims of your Group |
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| Section Two - Facilities
and Skills Base |
| 1) Does your group own facilities? (e.g. rooms
for meetings, sports facilities, computer facilities If no, go to question
2) |
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| If yes, specify type of facility |
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| Where is the location of the facility (e.g
Renmore) |
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| Are such facilities available on a rental/hire
basis to other organisations? |
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| 2) Do you have any skills/resources you would
like to share with other organisations? |
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| If yes, please specify type of skill/resource
(Please tick box or boxes) |
| Facilitation Skills |
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Enterprise Skills |
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| Working with Youth |
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Local Development Skills |
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| Childcare expertise |
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Training of Trainers |
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| PR Skills |
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Business Experience |
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| Working with Older People |
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Legal Skills |
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| Accountancy |
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Computer/IT/Web Design |
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| Others (Please specify) |
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| Section Three - Areas of Interest |
| 1) Which of the following is the main priority
area for your group? (Tick only one box) |
| Community |
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Environment |
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| Anti-Disadvantage |
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Culture |
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| Sport |
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Recreation |
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| Resident’s Association |
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Youth |
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| Heritage |
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Enterprise |
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| Other (Please specify) |
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| Often, when members of the Community Forum
are acting as representatives to other bodies, it is done on a cluster
basis. Please identify your specific area from Cluster A or Cluster B
(Please tick one box from either Cluster A or Cluster B). |
3) Please indicate which Local Authority policy
areas you are most interested in:
(Please tick no more than 3) |
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| Cluster A |
CLUSTER B |
| Community |
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Environment |
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| Voluntary |
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Conservation |
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| Disadvantaged |
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Culture |
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| Section Four - Contact
Details |
| Do you wish to join The Galway City Community
Forum? |
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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
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Signed:
(Member on behalf of group) |
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Please return the completed registration form to: -
Oisin Kenny,
Community Forum Co-ordinator,
Galway City Council,
College Road,
Galway. |
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| Telephone Number: 091 - 536 844 |
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