New Member Application Form 2009

Criteria for Membership:

1.       Application for membership of RFI shall be open to any person who is initiated into Reiki, in the presence of a Reiki Master.  Such member shall agree to abide by the Constitution of RFI including its appendices by signing the declaration below. All applications for membership shall be submitted to the Committee for its approval. 

2.       Copies only of all Reiki initiating certificates to be sent with completed membership form.

3.       Membership fee 75.00 euro to be enclosed with completed application form.

4.       Copy of current insurance certificate when available (necessary for inclusion on the Practitioner Listing).

5.       Membership renewal due one calendar year later.

SECTION 1            Personal Details Please use Block Capitals







Telephone No.: (w)                                   (h)


Mobile No.:


Date of Birth:     Day           /        Month           /            Year.

SECTION 2            Reiki Training (Please Attach Copy Certificates)



Date Attuned

Reiki Teacher / Masters Name

Duration of Training

Type of Reiki

Level 1

Level 2

Advanced (if applicable)

Reiki Master

SECTION 3            Practitioner Listing


Insurance Co. / Provider

Insurance Expiry Date

Please attach copy ins. cert.

Please indicate by ticking the appropriate box if you would like to be listed as

Practitioner c            Teacher c               Both Practitioner & Teacher c

(Please note that your insurance certificate must specify if you are covered for teaching in order for you to be listed as a Teacher)

Please Specify the information you would like displayed in the following categories:


Location: (Please specify the area(s) you wish to be listed under - A maximum of 2 listings allowed. 

Contact details (telephone and / or email): 

I hereby confirm that I have received, read and understood Reiki Federation Ireland Constitution (2003) and by my signature agree to abide by it.  I further declare that I have no criminal record that might prejudice the interest of clients and I have not been refused membership of any professional body or register in a related field on the grounds of professional misconduct and have no such complaints pending.  Disclosure of any relevant pending criminal, investigatory proceedings or enquiries should be made on a separate sheet attached to this application.
Signed: ____________________________________ Date: __/____/_____


RECEIPT NO.____________

MEMBERSHIP #: _________


EXPIRY DATE____________

Checklist for Enclosures:

o       Cash c Postal Order cCheque No.  _______ (made payable to Reiki Federation Ireland)

in full payment of 75.00 euro

o       Reiki Certificates - See no. 2 in Membership Criteria above

o       Evidence of insurance (Practitioners only)

Please forward to Annette Cullen, Administrator,
Reiki Federation Ireland, 42 Mc Kee Park, Blackhorse Avenue, Dublin 7   Phone: 087 9819366