NRRI MEMBERSHIP REGISTRATION APPLICATION FORM 2026

National Register of Reflexologists (Ireland)

Application

for

MEMBERSHIP

REGISTRATION
General Notes for Applicants:

1. Please aim to submit as much information as possible to support your application.

2. If you wish to include any additional information which is not included in this form please use field 'ADDITIONAL INFORMATION' just before signature page.

3. Fields marked as * are mandatory. Application cannot be submitted without them.

4. Please enter N/A in required fields which are not relevant in your application.

5. Copy of your Practitioner's Diploma is REQUIRED!

6. Professional Insurance is NOT REQUIRED, but optional.

7. First Aid Course is NOT REQUIRED, but optional.

8. Certificates of Post-graduate training/Other qualifications, are NOT REQUIRED, but optional.

!Tip1: prepare all files you wish to upload before starting the application ;-)

!Tip2: make sure that scans and photos are in good quality and readable!

9. If you wish to SAVE your progress and FINISH LATER go to Section D and find button 'SAVE'.

10. Make sure to choose Correct Fee to avoid complications. €100 registration fee applies only if you have an NRRI Student Number! If not sure what your fee is, please ask the Registrar.

12. The Payment section is at the very bottom of the form in Section E. Insert your card details and scroll up to Section D and Review the Answers.

13. When Sections A+B+C+E are done, go back to Section D, and click REVIEW ANSWERS! Only then you can SUBMIT your application.

14. Please allow 1-5 working days for the NRRI Registrar to process your application. You will be notified by email.

13. If in doubt, don't hesitate to contact Registrar on 086-8159855

Part A - Applicant's Details
1. Full Name*

First NameLast Name
Date of Birth (optional)

DayMonthYear
Date of birth
2A. Email*
example@example.com
2B. Work Email, if different (optional)
example@example.com
3A. Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
3B. Work Phone Number, if different (optional)
Please enter a valid phone number.Format: (000) 000-0000.
4. Correspondence/Home Address*

Street Address

Street Address Line 2

CityCounty

Eircode
5. Registered Trading Name (optional)
(Must be registered with CRO
6. Work Address, if not working from home (optional)

Street Address

Street Address Line 2

CityCounty

Eircode
7A. Business Website Address (optional)
Full URL e.g. https://www.xxxxxxx.xxx
7B. Business Instagram Page Address (optional)
Full URL e.g. https://www.instagram.com/xxxxxx
7C. Business Facebook Page Address (optional)
Full URL e.g. https://www.facebook.com/xxxxxx

Part B - Applicant's Qualifications
1. Name of Qualifying School*
(Full name)
2. Date Qualifed*

DayMonthYear
(Date)
3. Diploma Course Duration*
(Number of months)
4. NRRI Student Membership Number, if applicable
xxx(s):xx
5. Please upload Copy of Your Practitioner's Diploma*

(File preferably as .PDF or .JPG)
Cancelof
Not currently practisingAbout to commence part-timeCurrently practising part-timeAbout to commence full-timeCurrently practising full-time
7. Please upload proof of Professional Indemnity Insurance (for website listing)(optional) If you don't have insurance yet, no worries, we will guide you to an Irish broker upon registration. :-)

(Your Professional Insurance Certificate / File preferably as .PDF or .JPG)
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Please mark here, if you wish to receive details how to get one.
8. Please upload copies of other qualifications/post-graduate training (for the purpose of NRRI Continuous Professional Development Programme) completed within the last 24 months (optional)

(Copies of certs and diplomas / File preferably as .PDF or .JPG)
Cancelof
9. Please upload copy of valid First Aid Course (optional)

(Your First Aid Certificate / File preferably as .PDF or .JPG)
Cancelof
ADDITIONAL INFORMATION:
(If you wish to add information that is not included in this application)

Part C - Declaration & Signature

Please read, tick a box and sign/date this section
Declaration:

"I accept that the NRRI is an autonomous regulatory institution and undertake to comply with its rules and regulations and terms and conditions of membership.

I understand that NRRI membership is subject to annual renewal and can be withdrawn or suspended at any time at the sole discretion of the Registrar

I undertake to comply with the NRRI Code of Ethics and Professional Conduct as a condition of my NRRI membership.

I enclose a copy of my Qualifying Reflexology Diploma/Certificate together with my Registration Fee and I hereby Apply for Registration."
Yes, I declare.
By signing this form "I certify that the above facts are true to the best of my knowledge and belief, and I understand that my Membership will be rejected in the event the above facts are found to be falsified. "I hereby Apply for the NRRI Membership". Applicant's Signature*

Powered by Jotform SignClear
Date of submission:*

DayMonthYear
Date

Important: To SAVE your PROGRESS, please -> click on SAVE button -> click on Skip Create and Account -> Enter your EMAIL and -> click SEND! You will receive an email with link to CONTINUE your submission!

To SUBMIT press REVIEW ANSWERS then CONTINUE.

Part E - Payment

You can use your Debit/Credit Card or PayPal account
Registration Fee (incl. 1st year Membership)(choose one)*
prevnext( X )
FULL REGISTRATION (NRRI Graduates Only)
Holders of the NRRI Diploma

€100.00



FULL REGISTRATION (ITEC/CIBTAC/VTCT/FHT/other)
Holders of other than NRRI Diploma

€160.00



FULL REGISTRATION (SPECIAL RATE for Graduates of Schools: OBUS & ECRM)
Please use this option only if confirmed by the Registrar.

€130.00



ASSOCIATE REGISTRATION
For those wishing to practice in a non-professional capacity.

€80.00



Total

€0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Part A - Applicant's Details

Part B - Applicant's Qualifications

Part C - Declaration & Signature

Part E - Payment