Personal Details

(Include name as registered with your employer ie name on payslip)

First Name  
Home Address1  
Home Address2 Home Address3 Home Address4 Home Address5 Eircode:
Date Of Birth
Mobile Number

(Preferably Personal Email and not Work Place email)

* Please note, your home email address helps to ensure direct, safe and more effective communications with you than a workplace email address.

Employment Details

Grade/Job Description/Title  
Staff Number:  
Union Reference Number (If known)
If SNA or School Secretary, enter Roll Number (If known)
Workplace Address1  
Workplace Address2 Workplace Address3 Workplace Address4 Workplace Address5 Eircode:

Union Membership:

Do you want us to send a new membership card to you?

Building Momentum: A new Public Service Agreement

If you have not already received your electronic ballot by email do you now require a Unique Voting Code?

Fórsa is committed to processing personal data in accordance with the requirements of data protection legislation, namely the EU General Data Protection Regulation (GDPR) and Irish Data Protection Act 2018, and aims to maintain consistently high standards in protecting and securing all of your personal information. Any information requested is required to enable the union provide a service to members for balloting and communications purposes. . If you are not a member of Fórsa and have received a communication from us in error, by letter/email/text please notify the Data Protection Officer dpo@Forsa.ie to have the matter amended/information corrected. Our privacy statement can be viewed at www.forsa.ie.


* Please complete this form within 20 minutes.