Irish National Teachers Organisation

Irish National Teachers’ Organisation

MEMBERSHIP APPLICATION FORM FOR THOSE TEACHING IN A
PERMANENT/ CID OR TEMPORARY (FIXED TERM) CAPACITY

Do not complete this application form if you are working as a substitute or not paid directly by the Department of Education and Skills

Payroll Number: ______Teaching Council Number: ______

(Please circle): Mr / Miss / Mrs / Ms

First Name: ______Surname: ______

Date of Birth: ______

Home Phone No: ______Mobile No: ______

Personal Email: ______

Home address: ______

College of Education attended: ______

Teaching Qualifications Obtained: ______

Year Qualified: ______

School Name: ______School Roll No. ______

School Address: ______

State whether appointment is permanent/fixed term/CID: ______

Year of First appointment by DES: ______

Are you paid directly by the Department of Education and Skills? Yes 1 No 1

Signed: ______Date: ______

To be completed by the Branch Secretary

Branch: ______Signed: ______Date: ______

Completed application form received on: / / Applicant was accepted as a member of this Branch on: / /

Office Use Only: Date of Input / / Deduct. Commence / /

Voluntary Deduction at Source Mandate

I hereby authorise the Payroll Division of the Department of Education and Skills, to make a deduction directly from my salary in respect of the INTO and to pay this amount to INTO on my behalf. I understand and agree that:

·  The deduction at source facility is being made available solely as a matter of convenience to me

·  Beyond paying the sums deducted to INTO the Department of Education and Skills accepts no responsibility of any kind in the matter

·  The deduction is to commence as soon as possible and to continue until and unless I serve further written notice to INTO

·  The INTO has the right to alter the amount of this deduction in line with agreed amendments in the rate of subscription

·  Any arrangements for refund of deductions or collection of arrears are to be made directly with the INTO and that the Department of Education and Skills will not be responsible for such matters

·  It is my own responsibility to ensure the correct deduction is made from my salary and to notify INTO if I wish to amend or cancel the deduction from my salary

·  There may be a delay in commencing or ceasing my deduction due to payroll scheduling and the fact that amendments to mandates are submitted to the Department of Education and Skills on a monthly basis

·  I will correspond directly with INTO in relation to the deduction from my salary or the product that I am availing of.

·  It is a matter for the INTO to advise me of the withdrawal of the DAS facility and to contact me to make alternative arrangements for the collection of any monies due. I understand that the Department shall have no responsibility of any kind where policies of any nature lapse due to the withdrawal of a DAS facility.

I hereby consent to the Department of Education furnishing my current school location to the INTO.

Signed: ______Date: ______

Data Protection Notice

This Notice explains what the INTO will do with your information

The personal information requested by you is required to enable the INTO to effectively provide and administer your membership of the INTO. It is processed by the INTO in the course of our legitimate activities as a trade union. The fact that you are a member of a trade union is sensitive personal data under the Data Protection Acts 1988 and 2003 (the Acts) and as such is afforded special protection. We will not disclose any personal information about you which reveals your membership of the INTO without your explicit consent or where one of the other lawful processing grounds as set out in the Acts allows us to.

The information that you provide may be held by the INTO on a computer database and/or in any other way. We may use this information in the course of our legitimate activities as a trade union as follows:

·  To administer your membership of INTO;

·  To provide you with INTO updates by text and email;

·  To correspond with you in relation to membership of INTO, including corresponding with you at your school address and by text and email;

·  To provide you with ballot paper/papers at your school address in the event of an election or a ballot on industrial action;

·  To consider the make-up of our membership, in light of our trade union aims and objectives and ensure that the interests of our members are being served by INTO;

·  To process payments of your membership subscription;

·  To carry out statistical analysis of our membership or to instruct a third party to perform this on our behalf;

·  To provide your details to our solicitors and other legal advisors in the event of any legal action or legal advice which we may support on your behalf;

·  To provide your personal details to third party processors and contractors who act on behalf of INTO.

Where you provide your explicit consent:

1.  we will furnish your details to the Department of Education and Skills (DES) so that your subscription can be deducted from your salary and paid by DES directly to INTO;

2.  we will also send you INTO updates and other information by post to your school;

3.  we may also obtain your school identifier number from DES.

I hereby consent to the INTO processing my personal data for the purposes of 1, 2 and 3 above and I fully understand that by consenting to this I am consenting to the INTO disclosing to DES and/or my staff representative and/or my school that I am a member of INTO.

You may revoke your consent to the above at any time by writing to us at our registered office.

Signed: ______

Under the DPAs you have the right of access to personal information we hold about you on our records, You can exercise this right by writing to us at our registered office. If you become aware or believe that any of the information we hold about you is inaccurate or incorrect please let us know and we will correct it.