The Rural Centre

The Rural Centre

The Rural Centre
European Projects
Study Visits
Cultural Awareness Training
Contact

Registration Form

PEACEPLUS Cross Border Heritage Programme – Participant Registration Form

Section 1: Personal Information Full Name:

Date of Birth:

Gender:
Male Female Other Prefer not to say

Address:

Area:

Telephone Number:

Email Address:

History/Heritage Group:

Section 2: Community Background

Please tick the option that best describes your community background:

CNR (Catholic/Nationalist/Republican)
PUL (Protestant/Unionist/Loyalist)
Other:
Prefer not to say

Section 3: Emergency Contact Information Name:

Relationship:

Contact Number:

Section 4: Consent I give my consent to participate in the PEACEPLUS programme and related activities.
I give permission for photographs/videos of me to be taken and used for programme promotion.
I understand that my information will be kept confidential and used only for programme purposes.

Name:

Date:

© The Rural Centre 2026

Simple Business by Nimbus Themes
Powered by WordPress