LicencedProfess ion A ssociate A ssociate Diplom ate M em ber

Doctors Associate LFHom – M FHom

Nurses /midwives Associate LFHom – M FHom

Dentists Associate LFHom – M FHom

Pharmacists Associate LFHom DFHom M FHom

Podiatris ts Associate LFHom DFHom M FHom

Vets Associate LFHom – VetM FHom

A ssociate m em bership: open to all statutorily registered healthcare professionals(S R HCPs) who are interested inhomeopathy. R equires no previous trainingor qualification in homeopathy.

Licenced A ssociate: open to S R HCPs who have passed the Primary Health Care E xamination (PHCE ).

Full m em bership: doctors , nurses ,dentis ts , podiatris ts , pharmacists and vets who have passed the Faculty’sM embership E xamination may become full members of the Faculty and are entitledto use the letters M FHom or VetM FHom.

Fellow ship: Fellows are elected fromamong the full members and are entitledto use the letters FFHom or VetFFHom.

W H A T A R E T H E D I F F E R E N T L E V E L S O F E X P E R T I S E I N H O M E O P A T H Y ?

The Faculty has s everal levels of members hip and encourages members to progres s by taking cours es and pas s ing its examinations .

H O W T O J O I N

Please complete the application form overleaf and return it together w ith your payment to the Faculty of Homeopathy.

All members with a UK bank account areencouraged to pay their subscription by direct debit.

If you have any queries , please contactthe M embership Department at theFaculty.

Information about joint membership and concess ionary rates is available from the membership department.

F A C U L T Y O F H O M E O P A T H Y

M E M B E R S H I P A P P L I C A T I O N F O R MFA C U LT Y O F H O M E O PAT H Y M E M B E R S H I P P O L I C Y S TAT E M E N T

The Faculty of Homeopathy accredits and s ets the s tandards for the training,education and practice of homeopathy by s tatutorily regis tered healthcareprofes s ionals . M embers hip of the Faculty is only open to healthcare profes s ionalsholding a full and current regis tration w ith a UK s tatutory regulatory healthcarebody or recognis ed overs eas equivalent body.

The As s ociate level of members hip is not a qualification and does not confer anystatement of a practitioner’s ability to practise homeopathy. Under no circumstances,therefore, should a healthcare practitioner use Associate membership of the Facultyto state or imply a competence in homeopathy. Nor should Associate membershipbe us ed by a healthcare profes s ional to s ugges t any form of Faculty regis tration,endors ement or qualification. As s ociate members hip does not confer the rightto us e as a title “ As s ociate M ember of the Faculty of Homeopathy” or anyabbreviated form in a w ay that could lead others to mis interpret this category ofmembers hip as a formal qualification.

All members are bound to act within the competence of the healthcare profession(s)for which they hold current regis tration. The Faculty of Homeopathy will defer tomembers’ professional bodies for advice on the scope and limitation of homeopathicpractice that can be regulated within their healthcare profes s ion.

Faculty members are als o bound to act within the defined level of competence oftheir Faculty accredited training and qualification in homeopathy. M embers maypractis e homeopathy beyond the limits of their Faculty accredited qualificationonly under s upervis ion and as part of a Faculty of Homeopathy accredited trainingprogramme.

The us e of Faculty of Homeopathy members hip or qualification s tatus beyond theprivileges s et out in the Faculty of Homeopathy Act, its byelaw s and regulationsis prohibited.

Any breach of thes e conditions will be regarded as a dis ciplinary offence. S uch abreach could lead to a referral to the Faculty’s Dis ciplinary and P rofes s ionalP erformance C ommittee for inves tigation and the res ulting dis ciplinary actioncould ultimately lead to expuls ion from the Faculty. The Faculty Council may reportthe breach to the relevant s tatutory profess ional body following a recommendationof the Dis ciplinary and Profes s ional Performance Committee.

W H A T D O E S I T C O S T ?

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Diplom at: open to podiatris ts andpharmacists who have passed theFaculty’s Diploma E xamination.

Associates £120 (£ 115 outside Europe)

Licenced Associates £141 (£131 outside Europe)Diplomats £180 (£155 outside Europe)M embers /Fellows £242 (£178 outside Europe)R etired M embers £95

Paym ent by cheque I enclose a cheque payable to the Faculty of Homeopathy for £ . . . . . . . .

Credit card (we regret that we do not accept American E xpress)

I wish to pay by Visa/M astercard. Please charge £ . . . . . . . . to my account

Card number E xpiry date

Name (as on card) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

B illing address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Cardholder’s s ignature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

A N N U A L S U B S C R I P T I O N – M E T H O D S O F PAY M E N TPlease com plete one section below :

Direct debit (UK bank accounts only; please complete the Direct Debit instruction opposite)

FACU LTY OF HOM E OPATHY M E M B E R S HIP APPLICATION FOR M

Please complete this form and return it to: M em bers hip Departm ent, Faculty of Hom eopathy, 49-51 East Road, London, N1 6AH

Type of membership required: Associate Licenced Associate Diplomate M ember

Family name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Initials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Firs t name/s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Home address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

M ain work address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Preferred mailing address : Home M ain workIntroduced by (if applicable) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Profess ional inform ationProfess ion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Profess ional qualifications gained . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Place of training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Profess ional body and registration no . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date of registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Profess ional indemnity organisation and registration no . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I have read and agree to abide by the conditions of the Faculty of Hom eopathy m em bershippolicy (see page 4, overleaf)

I agree to have m y details lis ted in a m em bers-only, password-protected area of the website

S ignature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

INS TR UCTION TO YOUR B ANK OR B UILDING S OCIE TY TO PAY B Y DIR E CT DE B ITS

B anks and B uilding S ocieties m ay not accept Direct Debit Instructions for som e types of account

Please fill in the w hole form us ing a ball point pen and send it to:

Name(s) of Account Holder(s )

B ank/B uilding S ociety account number

B ranch S ort Code

Name and full postal address of your Bank/Building SocietyTo the M anager B ank/B uilding S ociety

Address

Postcode

Originators Identification Number

9 3 0 4 9 6R eference Number

Instruction to your B ank or B uilding S ociety

Please pay the Faculty of Homeopathy DirectDebits from the account detailed in thisInstruction subject to the safeguards assured bythe Direct Debit Guarantee

I understand that this instruction may remainwith the Faculty of Homeopathy and, if so,details will be passed electronically to myB ank/B uilding S ociety.

M em bers hip Departm ent Faculty of Hom eopathy 49-51 East Road London N1 6AH

S ignature (s )

Date

T H E D I R E C T D E B I T G U A R A N T E EThis Guarantee should be detached and retained by the payer.

This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.The efficiency and security of the Scheme is monitored and protected by your own Bank/Building Society.

If the amounts to be paid or the payments date change, the Faculty of Homeopathy will notifyyou 10 working days in advance of your account being debited or as otherwise agreed.

If an error is made by the Faculty of Homeopathy or your B ank or B uilding S ociety, you areguaranteed a full and immediate refund from your branch of the amount paid.

You can cancel a Direct Debit at any time by writing to your B ank or B uilding S ociety.Please also send a copy of your letter to us .