Linkage Group Member Registration Form

Linkage groups are the key link between PPN representatives and organisations on the ground.  There will be a linkage group for each committee where there is a PPN represenative.  All PPN member organisations have an opportunity to be a part of a linkage group in an area which interests them.  By becoming a member of a linkage group, you can vote to elect your representative and you are committing to regular communications with your representative  (mainly by email, but also some meetings).

Organisations should only join a linkage group where they have a significant interest and expertise in the relevant topic. 

This form refers to the Linkage Group for the South Tipperary Suicide Prevention Planning Group.

Please complete the following questions:

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* 1. Organisation Name

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* 2. Name of person completing this form

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* 3. Email address

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* 4. Phone No

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* 5. This organisation is interested in being part of a Linkage Group for South Tipperary Suicide Prevention Planning Group and operates in the municipal district(s) of:

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* 6. Under which PPN category is your organisation situated? (*Please note you were asked to choose one category upon registration with the PPN) 

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* 7. Please give us the names of two people who may attend the South Tipperary Suicide Prevention Planning Group Linkage Group on your behalf

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* 8. Do you agree to share your email address with your PPN Representatives for this group in order for them to gather input and feedback?

Thank you for completing this questionnaire.  We will be in touch with you in the near future.

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