NZROHA Membership Application

Membership Application
To apply for an NZROHA membership, please fill out the form below.

Please deposit the $45.00 Professional Member Application fee to:

NZROHA ASB 12-3039-0017356-00 with your name as the reference if you are applying for Professional Membership. There is no application fee for Associate Membership.

The application fee pays for the administration and screening of the application for approval, your professional membership certificate, annual professional membership certificate, and postage of certificates.
Name*

First NameLast Name
Organisation or Business Name (if applicable):
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Date of Birth*

DayMonthYear
Date
Application for:*

Professional Membership - NZD $120 per annum (to be paid after application approval.)Associate Membership - NZD $65 per annum

PROFESSIONAL MEMBERSHIP APPLICANTS MUST FILL OUT THE BELOW:

If you are applying for an Associate Membership, please go to the next page to the declaration portion of this application
You can find a breakdown of the Criteria for Professional Member details on the NZROHA become a member page.

Please upload copies of the following:
- Aromatherapy and Essential oils 200 hours
- Anatomy & Physiology Certificate 250 hours
- Aromatherapy Applications 140 hours
- Holistic Aromatherapy Consultation/Treatment 150 hours
- and current First Aid Certificate (or equivalent)
- Proof of continual development or continual education (experience counts as criteria hours)
- Other modalities: i.e. Chiropractor, Nurse, Naturopath, etc
Aromatherapy Training Course
Name of training provider
Course commencement date

MonthDayYear
Date
Qualification date issued

MonthDayYear
Date
First Aid Course
Name of training provider
Expiry Date

MonthDayYear
Date
Aromatherapy

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Anatomy & Physiology

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Aromatherapy Applications

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First Aid Certificate (or equivalent)

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Relevant Certificates & Other Modalities

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Continual Development or Education

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Type information or question here
Communications are welcomed
Professional Member I agree to have my name, telephone number and area or address of business listed on the NZROHA Website Member Directory which is available to the public:

YESNO

I have paid my Professional Membership Application fee or Associate Membership fee to the NZROHA ASB bank account today: 12-3039-0017356-00 *

YESNO
Payment information for International payments

Swift code: asbbnz2a
1) Bank Name ASB Bank Limited
2) bank address 12 Jellicoe Street ASB North Wharf
3) account name N.Z.Register of Holistic Aromatherapists Incorporated
4) account number 12-3039-0017356-00

Make payment into NZROHA via internet banking or at a bank branch.

Receipt of payment will be emailed by NZROHA Treasurer.
Receipt of payment will be emailed by NZROHA Treasurer. If you require an invoice before making payment, put the relevant information in the box below. i.e. employer is going to pay
Name, email, any other details
DECLARATION FOR ALL NZROHA MEMBERSHIP APPLICATIONS:

I solemnly declare that the above details are correct. I have read the NZROHA Rules, Code of Practice, the Code of Conduct and Conditions of Membership, (located on the NZROHA website, become a member page), and agree to abide by them. I have made payment to the above bank account for the appropriate membership fee.

PRIVACY POLICY DECLARATION FOR ALL MEMBERSHIP APPLICATIONS/RENEWALS:

Please note that contact details will be available for the purposes of the Register and distribution to EC members, the Registrars, and the NZROHA Editors of the Newsletter.

All members Name and Phone number will be on NZROHA Website Members only section.

Professional Members Profile details are published on the Professional Members Page, NZROHA website

By completing and submitting New Membership or Membership renewal on the Website to the NZROHA secretary you are granting/signing your permission.
I agree to the above declaration:*

YESNO
Should be Empty: