Community Group Support Application

Please refer to the Guidance Notes in the right hand column while completing this form

Required*

Name of Group*

Main Contact*

Username*

Password*

Repeat Password*

Please select your primary target areas.

Castlereagh East Castlereagh South Downshire East Downshire West Killultagh Lisburn North Lisburn South

Email Address*

Address 1*

Address 2

Town*

Postcode*

Telephone*

Mobile

Please list all group committee members by title and name.

Name	Title

Add another Committee Member +

Please select main group focus.

Community Group Arts Group Older Persons Group Youth Group Specialist Group

Please indicate the main activities, aims & objectives of
your group/organisation *

How many people are involved in running your
group/organisation? *

Committee Members

Volunteers

Staff

Where does the group operate from?.

Community / Village Hall Community House / Flat Commercial Premises Hired Premises No Premises

Guidance Notes

Please provide the name and contact details of someone who will be in a position to speak about this application

The postal address inserted here will be used as the main postal address for any communication from the community services section of Lisburn & Castlereagh City Council

PLEASE INSERT A FULL POST CODE