New Membership Application

New Membership Application form

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*
Name*
First Last
Address*
Street Address Address Line 2 City County Eircode / Postcode Country
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!)

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

IRH New MemberApplication Form