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Rivers Trust Expression of Interest Form NAME:

___________________________

Address: PHONE NO. 1.

DATE: __________________________

_______________________________________________________________ _________________________ EMAIL: _______________________________

Are you a member of a group or organisation? Yes

No

If yes, what is the name of the group: ______________________________________

2.

Location (Postcode/Council Area):

3.

In what capacity would you like to get involved? (please tick one) • I would like to be actively involved in the formation of a Trust or Association i.e. Committee/Board member •

______________________________________

I would like to be kept updated regarding the formation of a Trust or Association and its activities

Other, please specify: __________________________________________________ 4.

Area of Interest: (Tick appropriate) Angling

Education

Amenity

Heritage

Biodiversity

Water Quality

Business/Industry

Flooding

Other (please detail): ________________________________________________________

5.

Additional Comments: _______________________________________________________

________________________________________________________________________________ The Local Authority Water and Communities Office is a data controller under the Data Protection Acts, 1988 and 2003. The personal data supplied on this form will be added to a mailing list for A Dodder Rivers Trust or Association and will be maintained by The Waters and Communities Office and The Trust / Association. It will not be used for any other purpose and will not be distributed to any other organisations or systems. If you wish to be added to this

mailing list tick here:

Sinead Hurson | Community Water Officer

 085 8083725 | shurson@lawco.ie

Profile for Dodder Action

Expression of interest form, Dodder Rivers Trust  

Expression of interest form, Dodder Rivers Trust  

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