National Partner Society Application form

1 Your society 2 President 3 Secretary 4 Main contact 5 Additional contacts 6 Complete

Please complete all required sections below to enable us to process your application

Society name *

Date society set up *

Day

Month

Year

Aims and objectives of society *

Number of members *

Who is your Society's Governing Body, e.g. a Council, An Executive Committee? How many members are on this Governing Body? *

ESE Advocacy Representation Scheme (EARS)

As part of your application to become an Affiliated Society a National Partner Society a contribution of €2.50 per member is payable to join the ESE Advocacy Representation Scheme – see the website for full details about EARS here. Becoming part of the EARS Community is at no cost to the members of the national affiliated societies National Partner Societies represented by the ESE Council of Affiliated Societies (ECAS), as the small annual fee of €2.50 will be paid on their behalf by their National Society. Please note that this is separate to any existing ESE membership. This contribution will help support ESE’s Policy and Advocacy work on behalf of all our members.

EARS invoicing details

VAT/tax number *

Invoice contact name *

Street Address *

City *

Postal Code

Country *

State/Province

Society general email *

Society phone number *

Society website URL *

Why is your Society interested in applying for National Partner Society Membership? *

Constitution *

Please provide a copy of your Society's Constitution (in English language)
More information

Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Meetings - frequency, number of delegates *

Newsletter – frequency *

Other activities (please list) *

Leave this field blank