Membership Registration New Membership Registration Step 1 of 7 0% HiddenDat of Submission Welcome to the Association of Master Herbalists’ Member Registration form. This form allows you to apply as a Practitioner Member and will create an account for access to the Member Portal. Please note that you will not have access to the Member Portal until your membership has been approved Personal Details Name(Required) DrMissMrMrsMsProf.Rev. Title First Last Date of Birth(Required) DD slash MM slash YYYY Nationality(Required) United Kingdom European Union Other What is your Nationality?(Required) Do you need a work permit or visa?(Required)If you are not from the UK or Europe Yes No Membership Type(Required)Please choose your membership type Qualified Practitioner Member Student Herbalist Login DetailsUsername(Required)This will be used when logging in. Email(Required) Enter Email Confirm Email Password(Required) Enter Password Confirm Password Strength indicator Contact DetailsAddress(Required) Street Address Address Line 2 City County / State / Region Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Public Phone Number(Required)Other Phone NumberPractice Website Relevant QualificationsProfessional Herbal Qualification(Required)e.g. Diploma or Degree Please Provide Diagnostic Techniquee.g. Iridology Name of School/Course Provider(Required) Date of Qualification / Certification(Required) DD slash MM slash YYYY Other Complementary or Alternative Medicine QualificationsPlease give details of any other CAM therapies currently practised or being studied.Please list your reasons for wishing to join The Association of Master Herbalists*Membership of other Professional Associations (UK or overseas) Study Course DetailsHerbal Medicine Course(Required)E.g. Diploma / Degree / Post Grad / Online / In-Person Name of School / Institution(Required) Course Start Date(Required) DD slash MM slash YYYY Course End Date(Required) DD slash MM slash YYYY Diagnostic Technique(s)Other Relevant Studies or QualificationsMembership of Other Professional Associations (UK or overseas)Please list your reasons for wishing to join The Association of Master Herbalists(Required) DeclarationHave you been convicted of a criminal offence, received a police caution or been convicted of a criminal offence for which you received a conditional discharge?(Required) Yes No Have you had civil proceedings (other than a divorce/dissolution of marriage or civil partnership) brought against you?(Required) Yes No Have you been disciplined by a professional or regulatory body or your employer?(Required) Yes No Have you ever been refused admission to a professional register?(Required) Yes No Do you have any physical or mental health condition that would impair your fitness to practise the profession to which your application relates?(Required) Yes No If you answered is yes to any of the questions above, please give details in the text box below.(Required) Terms Agreement On submitting this form I confirm that the information given is correct and that I am happy for certain information to be verified. I will upload now, or email (masterherbalists@gmail.com) ASAP: My C.V. Copies of my Certificates of Qualification, Professional Indemnity Insurance and current First Aid Certificate. Recent colour ID photograph (head & shoulders only). 2 pre-written personal references (neither referee can be a family member). Terms Agreement On submitting this form I confirm that the information given is correct and that I am happy for certain information to be verified. I will upload now, or email (masterherbalists@gmail.com) ASAP: Proof of study course attended Photo ID Choose an option(Required)Choosing Email submission may cause delays to your application, please send them ASAP if you choose this option. I want to upload the documents now I want to email the documents Upload your files(Required) Drop files here or Select files Accepted file types: doc, jpg, gif, jpeg, png, pdf, xls, docx, xlsx, Max. file size: 512 MB. Let us know how the AMH can benefit you and your practice(Required)Please view our Privacy Policy and our Terms and Conditions before completing registrationTick this box to confirm that you agree with our terms and conditions and privacy policy(Required) I have read and agree with the terms and conditions and privacy policy for membership of The Association of Master HerbalistsData Protection From time to time we are approached by organisations and businesses with an interest in Herbal Medicine for details of our Members. These are carefully vetted and assurances sought as to what the information will be used for. If you DO NOT want your details to be given out please tick the boxSignaturePhoneThis field is for validation purposes and should be left unchanged.
