APPLICATION FOR FULL MEMBERSHIP
Please print clearly in capital letters
Full Membership runs from 1st Jan - 31st Dec inclusive, and is renewed each year in January.
(Office use only M . . new / upgrade from S .. . Received . ./ . / . Council approval . ./ . ./ . .)
First Name ______________________ Surname ___________________________
Postal Address ______________________________________________________
Town_______________________________ State _________ Postcode _______
Telephone number H (___)______________________ W (___)________________
Telephone mobile____________________________________________________
Practice Name ______________________________________________________
Practice Address_______________________________________________________
Suburb _____________________________________Postcode___________
Practice Telephone Number (__)_________________ Fax: (__)________________
Email _________________________________________________________
Website_________________________________________________________
Documentation Required;
All copies of your documents (Certificates and Diplomas) MUST be certified by an authorized person (as per Application instructions) stating that they are a copy of the original.
- Aromatherapy qualifications (IFA accredited
course) (office use only C
.
..Grad
.
/
.
/
.
)
Copy of Diploma/Certificate
+ Academic transcript.
- First Aid Certificate Senior / Level 2
qualifications (Must be current) (office use only Exp
.
/
.
/
.
)
- Insurance Cover Professional Indemnity,
Public Liability for the practice of Aromatherapy & Blending Essential Oils.
(A certificate of currency needs to be supplied, not a receipt of
payment) (office use only Ins
.
Exp
.
/
.
/
.
)
If you do not have insurance cover, please contact Oamps (1 800 222 012) regarding our IFA sponsored insurance scheme.
- Additional Modalities
Should you have full qualifications in other modalities relevant to Aromatherapy, please enclose documentation. Nurse, Remedial Massage, Beauty Therapy etc. and if recognized by other associations.
(office use only Mod )
Declaration:
I have read and agree to abide by the IFA Code of Ethics and Code of Practice, to uphold the IFA Constitution and promote the professional practice of Aromatherapy. As a full member I agree to obtain 20 hours per year of ongoing professional development, renew malpractice insurance and workplace first aid certification on expiry.
Signature _____________________________________ Date ________________
- Please add my details to the IFA Websites
- Please include my details on the IFA full Membership Directory.
Signature _____________________________________ Date ________________
Payments
| Australia | Join before July 1 | Join after July 1 |
| Full Membership | $165.00 | $ 82.50 |
| GST | $ 16.50 | $ 8.25 |
| Total amount owing | $181.50 | $ 90.75 |
| . | . | . |
| Overseas | Join before July 1 | Join after July 1 |
| Full Membership | $210.00 | $105.00 |
| Total amount owing | $210.00 | $105.00 |
(Office use only M........................................................................................ ..........)
I enclose my: (circle payment method) Cheque / Money Order / Credit card for $______
Please charge this fee to my : (circle one card) MasterCard / Visa / Bankcard
| Card number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ | Expiry date: __ __ / __ __ |
Cardholders signature: _______________________________________________
Please return this application, documentation and payments to:
IFA Australian Branch Inc, PO Box 215, Burwood, NSW 1805 Australia
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