"Supporting markets and market traders throughout Ireland with expert advice, assistance and exclusive and competitive
insurance products!"
MAST Ltd, Phone 01-2300788  Fax: 01-2300788  Mobile: 087 697 1751  Email: info@mast.ie
Clarinda Mews, 23 Clarinda Park West, Dun Laoghaire, Co.Dublin, Ireland
[Home][Join MAST][Find a Market][What's On][About us][Contact MAST][Links]

MAST Membership Application Form



Proposed member details
Name
Yes
No
Yes
No
Yes
No
Yes
No
Please confirm your agreement, by typing your name & the date.
Name
Date
Please tick here if you do not wish this information to be utilised for this purpose.
Please note that the details you are being asked to provide may be used to give you information about other products and services from either Liberty Insurance dac or Frank Glennon Ltd. The fact that you choose not to receive such information will not affect any aspect of the facilities provided now or in the future.
Frank Glennon Limited, trading as Glennon and Glennon Insurances is regulated by the Central Bank of Ireland.
Address
Mobile
Landline
Date of birth
Trading Name
Email address
Web address
Facebook
Twitter
Please tick the boxes that apply to you...
Are you a Market/Event Trader?
Are you a Home Baker/Sugarcrafter?
Are you a Street Entertainer?
Do you hold classes/workshops?
Other - please specify..
Are you a Market/Fair/Event Organiser?
Are you a Artist/Crafter?
Are you a Face Painter/ Childrens' Entertainer?
Details of trading: Produce, Goods, Services
Please advise number of stalls run by you at any one time.
Note: Two or more stalls at the same time will incur an extra charge.
Trading locations:
Have you or any employee ever been convicted or charged with a criminal offence?
If 'yes', please provide details below.
Benefits required:
Public Liability Only
Products Liability (Food Only)
Products Liability for Products Other than Food*
Employers Liability**
Goods in Transit
  * Please provide product details below.
     Products Liability for non-food is quoted separately.
** Employers Liability is quoted separately.
Membership required:
Annual Multi Cover (multiple markets/locations)
Annual Solo Cover (single location only)
Hot Food
Short Term (1, 2 or 3 days - single location)
Short Term (1 month - single location)
Short Term (1, 2 or 3 days - multiple locations)
Have you had any insurance claims in the last 3 years?
Have you completed a HACCP course? (food vendors only)
Do you have HSE Certification?  (food vendors only)
* Details of Insurance available on request.
DATA PROTECTION:  The information you provide about yourself and about third parties will remain confidential and may be used for the provision and administration of insurance products and related services. This information will be processed and held on the computer systems of MAST, Frank Glennon Ltd, or Liberty Insurance dac and manual record systems. A person may request in writing, a copy of details about himself/herself held by  MAST, Frank Glennon Ltd or Liberty Insurance dac by sending a written request to the Data Protection Compliance Officer, Liberty Insurance dac, The Liberty Centre, Blanchardstown Retail Park, Blanchardstown, Dublin 15, D15 YT2H together with payment of the applicable fee (currently 5). There is also a right to correct any inaccuracies identified in the personal data.

DECLARATION: I/We declare that the statements and particulars given in this Membership Application are, to the best of my/our knowledge and belief, true and complete and that this Membership Application will form the basis of  my/our contract for Membership Insurance Benefits with Liberty Insurance dac. I/we confirm that I/we am/are giving my/our permission for the information provided in this form to be used for the purposes set out in the Data Protection section above.
                      Phone: 01-2300788 or 0876971751