Irish Reflexologist's Institute

Promoting Professional Reflexology in Ireland

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Membership Renewal Form

Please complete this Membership Application Form to renew your IRI Membership.

PERSONAL INFORMATION

Name *

First

Last

Gender *

Date of Birth *//

IRI Membership Number *

CONTACT INFORMATION

Email *

Email

Confirm Email

Please enter it twice to ensure no typing errors.

Phone *

Address 1 *

Address 2 (if needed)

Town *

Eircode (optional, but recommended)

County *

INSURANCE

Name of Insurance Company *

Policy Number *

Expiry Date *

FIRST AID

Do you have a Current Professional First Aid Certificate or a Healthcare Provider's Card? *

First Aid Certificate
Healthcare Provider's Card

Name of First Aid course provider *

Title of course as stated on your First Aid Certificate *

Only if you have a First Aid certificate.

Expiry Date on First Aid Certificate *

Only if you have a First Aid Certificate.

Type of Healthcare Provider Card *

Only if you have a Healthcare Provider Card

Expiry Date on Healthcare Provider Card *

Only if you have a Healthcare Provider Card

Continuous Professional Development (CPD)

I confirm I have completed 100 CPD points for my renewal application *

NO
YES

LEGAL RECORDS

Is prosecution pending for a criminal offence? Or have you been convicted of a criminal offence in the last 12 months? *

NO
YES

Please provide details

This does not automatically exclude you from membership, we need to make an assessment.

Are you currently on the Sex Offenders Register? *

NO
YES

Please provide details

WEBSITE LISTING

This section is only if you want to be added to the Website Listing or change your listed details Add the details you wish to be listed on the Find A Reflexologist page. If a box is empty, it is assumed you do not want that item on the website. Your personal address is not added, only the locality.

Do you want change your listing on our website? *

YES
NO

Name for Public Viewing

First

Last

Public Phone

Public Email (optional)

Website / URL (optional)

Name of Therapy Practice - if any (optional)

Town(s)

If you list more than one town, all locations will be listed. Your listing will be placed under the first town you provide and will be listed once in that county.

Website Listing Disclaimer

By opting to list your details in the “Find a Reflexologist” search, you permit Irish Reflexologists’ Institute Ltd to pass your name and contact details to persons and organisations who enquire about Reflexology. The IRIL does not and cannot control who receives this information, and cannot be held liable for any matters arising from the provision of these details.

LEGAL AGREEMENTS

I provide formal consent to the following in order to be a member of the Irish Reflexologist's Institute.

GDPR Agreement *

I consent to having the Irish Reflexologist's Institute Ltd retain the information provided in this form. I understand it will be processed as needed for the operations of my membership as determined by the governing committee, staff and IRIL constitution. I understand this may include sharing details with Healthcare Insurance Providers or Third parties as deemed necessary for my membership

Code of Conduct & Ethics Commitment *

I, the undersigned, hereby apply to be a member of the Irish Reflexologists’ Institute Limited. I agree to be bound by the Irish Reflexologists’ Institute Limited Code of Ethics and Practice.

Insurance Commitment *

I agree to always hold Public Liability and Malpractice Insurance (clearly stating Reflexology as a therapy covered) whilst in Membership. I agree to provide copy of my Insurance Policy as requested during an audit review of my membership

First Aid Certifcate *

I agree to always hold current First Aid Certificate/Health Care Provider Card whilst in Membership. I agree to provide a copy of my First Aid certificate/Heath Care Provider Card as requested during an audit review of my membership

CPD *

I agree to maintain 100 CPD points for my annual renewal whilst in Membership. I agree to provide copies of all CPD Certificates/details and CPD Form as requested during an audit review of my membership

IRIL Logo Usage Contract: For Full members who wish to use IRIL Logo on your business stationery. *

I agree to be bound by the following in relation to the IRIL Logo.The IRIL logo belongs solely to the Irish Reflexologists Institute Limited. Usage of said logo is allowed only by current , up to date members of the Institute in conjunction with usage as a member of the institute; any breach of same, using the logo without making evident that it is the logo of the IRIL, is a breach of the terms of usage and an infringement on the ownership of same to the IRIL which will result in a suspension of membership.

Declaration *

I declare that all information supplied is true & accurate. If this is found not to be the case, members can be suspended or expelled from the institute at the IRIL Board’s discretion.

Payment

Membership Type

Total

€ 0.00

Credit Card *

Card

Name on Card

Phone

FIND A REFLEXOLOGIST

Courses, Workshops, Events

Recent news

Zoom Session with Catherine Clooney Monday 8 Nov @ 7.30pm 18/10/2021
Hand Stretching, Relaxing and Breathing Exercises For Therapists with Anita Siegl 10/10/2021
Zoom Evening with Nuala O’Connor Monday 1st November @7.30pm 08/10/2021
Zoom Class Peter Murphy Monday 18 October @ 7.30pm 08/10/2021
Zoom Class – Friday 22 October- First Aid For Everyone 29/09/2021

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