Candidate Application — Independent Ireland

Councillor Website Update Details

Please complete the below details for updating your individual webpage on the Independent Ireland website.

Name

First Name

Last Name

Council Email

Council Phone

(###)

###

####

Your LEA/Constituency

Your social media links

(please provide details)

Other information

Please provide any other relevant information in relation to your application

Privacy

By submitting this form I agree that my details will be used by Independent Ireland to contact me by phone, email and/or text to discuss my application. If you want more information on your rights or our full privacy policy or how Independent Ireland holds your data and how it will contact you see our privacy policy in the footer of this page.

I agree to the above

Councillor Details

Councillor Website Update Details