Application form

Section 1 – General Information

Title Mr Ms Mrs Dr Email
First name
Home address 1
Last name
Home address 2
Suffix
City/Town
Telephone (Landline) County
Telephone (Mobile) Country
Date of Birth (DD/MM/YY) Nationality

Section 2 – Membership Information

Have you ever been a member of the ISH? Yes No If yes, when?
If a Student, course attending Current Year of Study
If qualified, course name and date of qualification Insurance Details (Company, Policy No. & Expiry Date) if applicable

Section 3 – Declaration

Has your application for membership to any other professional organisation ever been refused?  Yes No
If yes, please give details
Do you have any special requirements or circumstances that you would like us to take into account when processing your application?   Yes No
If yes, please give details
By submitting this form I confirm that:
  • I do not have any convictions for sexual offences or for abusing the trust of others in my care
  • I have read, understood and agree to the terms and conditions of the Registration process
  • I confirm that I will maintain up-to-date insurance
  • Upon acceptance of my application I undertake to abide by the regulations and Code of Ethics and Practice of the Irish Society of Homeopaths
  • I certify that the above information is true and correct.
Please note the following:
  1. No member shall utilise the name, goodwill or facilities of the ISH for monetary gain, to enhance personal reputation, to solicit patients or to obtain personal wealth
  2. Only those on the Society’s Register may use the titles “Registered Homeopath”, “Registered with the Irish Society of Homeopaths” and the abbreviation “IS Hom”
  3. Members not on the Register may not use their membership nor the name of the Irish Society of Homeopaths nor any variation for professional purpose
  4. The Society has the right to refuse admission at their absolute discretion.
 
I wish to apply for membership of the Irish Society of Homeopaths 
  • Upon acceptance of my application, I undertake to abide by the regulations and Code of Ethics and Practice of the Irish Society of Homeopaths
  • I enclose/have already forwarded a signed copy of the ISH’s Code of Ethics and Practice and understand that my application can not be processed until I forward it to the ISH Office - Click here to download "Code of Ethics and Practice" *
  • I certify that the above information is true and correct.