New Membership Application New Membership Form New Membership Application form Step 1 of 7 14% IRH New MemberApplication Form Missing information will slow down your application. The IRH is a voluntary organisation. Please be patient. If you have not heard from us after 28 days please get in touch at: membership@irh.ie Section 1: Member Contact Information Select your title*MrMrsMissMsDrName* First Last Address* Street Address Address Line 2 City County Eircode / Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Website Primary Email Address* Enter Email Confirm Email The main email address we will contact you with. A private email is advised.Secondary Email Address (Optional) An additional email such as a business email.Main Phone*Work Phone (Optional)Mobile Phone (Optional)Home Phone (Optional)CAPTCHA Section 2: Membership Type and Payment Details Payments by cheque (payable to the 'Irish Register of Herbalists') will not be cashed until membership is verified. If you wish to pay online a PayPal link will be sent to you once your membership application has been verified. Membership Options* Full Membership (130€) Student Membership (20€) Associate Membership (50€) Descriptions: - Full Membership (Full or Part-Time Practice) - Student Membership. From approved course. - Associate membership (Non-Practicing). Associate members can upgrade to full membership in time. Please see membership guidelines on the IRH website.Select Payment Method* Cheque Paypal Online Postal Order Please note: Paypal Payment will include the transaction fee. Full Membership - 134.77€ Student Membership - 21.07€ Associate Membership - 52.12€ Do you wish to support the work of the IRH with a donation?* Yes No Donation Amount in €*I wish to support the work of the IRH and enclose the following donation (Thank You!) Section 3: Membership Information Qualification / Training*Please select the relevant options: Certificate Diploma BSc. PG Cert. PG Dip. MSc. PhD. Other Qualification / Training Establishment(s)*List the establishment(s) where you received/are receiving your training (include type and date of qualification):Have you otherwise trained in herbal medicine through a traditional apprenticeship?* Yes No Please give details about your Traditional Apprenticeship*Would you like to receive information from IRH by email ?* Yes No Enter your preferred email for the newsletter* Are you qualified in any other health-related disciplines?* Yes No Other Disciplines*Please list any other qualifications here:Do you have a separate insurance policy for these other disciplines?* Yes No Other Professional AssociationsAre you a member of another Professional Association?* Yes No Have you previously been a member of another Association?* Yes No Please tell us why you are no longer a member*The IRH may ask for a letter from your previous association to ensure that you have not been expelled from that organisation.Confirmation of Good CharacterI confirm that there are no undisclosed issues relating to my good character, including any criminal or civil proceedings or disciplinary matters with my employer or other professional bodies.* Yes No Do you authorise the IRH to carry out a background check?* Yes No Do you currently have an insurance policy for herbal medicine?* Yes No Please attach your current up-to-date Insurrance Policy*Accepted file types: pdf, doc, docx, jpg, png, jpeg, Max. file size: 10 MB. Would you like to avail of the IRH Block Insurance Scheme?*This is only available to Full Members Yes No If yes please visit the IRH website contact page and send us a message to request for the insurance form . This form should be sent back to the Insurance Company and NOT to the IRH.Helping outWould you be interested in helping with the work of the IRH?* Yes No In what capacity?* Select All Committee IRH Physic Garden Herb Patch Project National Herb Week IT Other Extra InformationPlease give an indication what else you think might be of help. If you would like to help with the work of the IRH please let us know the times and date you are generally available on Full Membership Application Full Member consent 1*I understand that to be a Full Member of the IRH that I have graduated from an establishment which meets the IRH Core Curriculum criteria and that I am legally obliged to hold an appropriate insurance policy to practice as an Herbalist in Ireland (inc. Northern Ireland) or other countries where I practice. I understand that if I do not have adequate insurance at any time during my IRH membership then my IRH membership is invalid and I may incur a penalty. I understand.*Full Member consent 2*I understand that I must supply copies of all the following documents when first applying for Full Membership; a relevant CV, appropriate certificates (qualifications and insurance), 2 professional references and a photograph. I understand.*Full Membership File Upload* Drop files here or Select files Accepted file types: jpg, png, pdf, gif, doc, docx, jpeg, Max. file size: 10 MB. Please upload the following: - 1 Photograph of you (Full front face like on a Passport) - 1 relevant CV - Relevant Qualifications (Certificate(s) or Diploma(s) in Herbal Medicine) - 2 Professional references Any missing documents may delay your application validation. Full Member consent 3*I agree to undertake 100 CPD points per annum in support of my ongoing membership. I understand I may be subject to an audit from time to time. I understand.*Full Member consent 4*I agree to undertake 100 CPD points per annum in support of my ongoing membership. I understand I may be subject to an audit from time to time. I understand.*You do not need to submit CPD information when first applying. Full details of CPD requirements are available to Full Members in PDF form in the membership Resources section of the IRH website. You need to sign in to access this. You will get details to access this upon membership validation. Associate Membership Application Associate Member consent 1*I understand that to be an Associate Member of the IRH that I have graduated from an establishment which meets the IRH Core Curriculum criteria (or I have studied through a traditional apprenticeship) but that I will not be engaged in practice, for example due to a career break or maternity leave; because I am in the process of upgrading to Full Membership or that I am a graduate of a course which does not meet our entry threshold. I understand.*Associate Member consent 2*I include a photograph with this application. I understand.*Associate Member consent 3*Associate members are expected to pursue 50 CPD points per annum if they intend to upgrade to full membership. I understand.*Associate Membership File Upload*Please upload the following: - 1 Photograph of you (Full front face like on a Passport) Any missing documents may delay your application validation. Accepted file types: jpg, png, pdf, gif, doc, docx, jpeg, Max. file size: 10 MB. Student Membership Application Student Member consent 1*I understand that I can join the IRH as a student member provided I am studying on a reputable course which ideally meets the IRH Core Curriculum criteria. I understand.*Student Member consent 2*I may also join as a student if I am on another course which doesn't meet the IRH Core Curriculum criteria but if I intend to become a practitioner I understand that I will have to go through the IRH grand-parenting scheme. I understand.*Student Member consent 3*If my insurance is not covered or if practicing outside of my course (i.e. to gain extra clinic hours under private supervision), I have organised private insurance and enclose a copy of the insurance certificate and a letter from the supervisor. I understand.*Student Member consent 4*I enclose a letter from the school at which I am studying and attach it with this application. I understand.*Student Member consent 5*I include a photograph with this application. I understand.*Student Membership File Upload*Please upload the following: - 1 Photograph of you (Full front face like on a Passport) - Proof of Student Insurance (if not already given earlier) - Letter from your Herbal Medicine School and/or Proof of admission Any missing documents may delay your application validation. Drop files here or Select files Accepted file types: jpg, png, pdf, gif, doc, docx, jpeg, Max. file size: 10 MB. Main Consent 1*I declare that I have not been struck off or had to cease the practice of herbal medicine for any legal reason; nor am I currently involved in such a process. I agree*Main Consent 2*I agree to have my data, as detailed above, held by the IRH to fulfil the IRH membership requirements and I understand that it will be held in accordance with the General Data Protection Regulations 2018 which have been explained to me. I agree*Main Consent 3*I agree to be included on the IRH mailing listand to receive any relevant information from the IRH in relation to any events, news and activities pertaining to the work & projects of the IRH in the broader field of herbal medicine and CAM. I agree*I understand that I can opt out of the above consents by emailing the IRH at any time. Constitution*I confirm that the above information is true and correct and authorise the IRH to make the necessary reference checks in connection with this application. I have downloaded and read the current IRH Constitution and the current IRH Code of Ethics (available by following this link) and hereby agree to abide by these documents. I confirm*Breach* I understand that the award of memberships is at the discretion of the IRH committee. I understand that if I am in breach of the IRH Constitution or the IRH Code of Ethics that I may be fined or subject to expulsion. I understand*Signature*If there are any changes to your details following your application please get in touch with membership@irh.ie
