Full Member request

Please complete and return the form for the category you are selecting. We will send you back an email to confirm your registration request as well as a link to finalize and pay for your registration. Your application can take up to 28 days to process, longer if returned incomplete. PLEASE DO NOT PAY FOR YOUR SUBSCRIPTION BEFORE YOUR REGISTRATION REQUEST HAS BEEN ACCEPTED.

Select your category

Healing Practitioners

First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country

Email Address

Phone

Website

School/Training provider name & address

Dates to/From

Qualification (if applicable)

Date of Certification (if applicable)

Insurance company Name

Insurance company Address

Policy number

Valid until

Does the policy clearly state SPM is one of the therapies covered?

I understand that to be accepted as a Healing Practitioner Full Member (Ireland & UK members only) it is a requirement that I hold valid professional indemnity insurance at all times, and if I do not have adequate insurance at anytime during my FSPM membership then my FSPM membership becomes invalid.

Have you ever been convicted of, or is prosecution pending for, a criminal offence in any country?

Have you ever been, or are you currently, on the Sex Offenders Register in any country?

If the answer is yes to one of the 2 previous questions, please provide us with additional information at foundationsacredplantmedicine@gmail.com

I agree

Please provide name, address & contact details of 2 people the FSPM may contact as referees

I enclose copies of all necessary documents (qualification & insurance if applicable), contact details for 2 people who are willing to provide character references & I agree to undertake annual CPD (Continual Professional Development) as required by FSPM.

Please list my contact details on the FSPM online register

I would like my contact details to be made available to Full and Associate Members so that I can be kept informed of regional meetings

I would like to be included on the FSPM mailing list and be kept up to date with any relevant events, training, news or activities relating to the work of the FSPM

Please tick if simultaneously applying for membership in another category

Priestesses and Priests Makers, Growers and Communicators

I do hereby apply for Full Membership of the Foundation for Sacred Plant Medicine. If elected, I will abide by the Constitution and faithfully adhere to the Foundations Code of Ethics, acting in alignment with the Core Values and in furtherance of the Foundations Aims & Objectives.

I understand membership is awarded at the discretion of the FSPM and that if I am ever in breach of the FSPM Constitution or the FSPM Code of Ethics then my membership may be revoked.

I confirm all the information I have provided in this form is true and accurate.

Priestesses and Priests

First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country

Email Address

Phone

Website

School/Training provider name & address

Dates to/From

Qualification (if applicable)

Date of Certification (if applicable)

Have you ever been convicted of, or is prosecution pending for, a criminal offence in any country?

Have you ever been, or are you currently, on the Sex Offenders Register in any country?

If the answer is yes to one of the 2 previous questions, please provide us with additional information at foundationsacredplantmedicine@gmail.com

I agree

Please provide name, address & contact details of 2 people the FSPM may contact as referees

Please list my contact details on the FSPM online register

I would like my contact details to be made available to Full and Associate Members so that I can be kept informed of regional meetings

I would like to be included on the FSPM mailing list and be kept up to date with any relevant events, training, news or activities relating to the work of the FSPM

Please tick if simultaneously applying for membership in another category

Healing practitioners Makers, Growers and Communicators

I understand membership is awarded at the discretion of the FSPM and that if I am ever in breach of the FSPM Constitution or the FSPM Code of Ethics then my membership may be revoked.

I confirm all the information I have provided in this form is true and accurate.

Makers, Growers and Communicators

First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country

Email Address

Phone

Website

School/Training provider name & address

Dates to/From

Qualification (if applicable)

Date of Certification (if applicable)

What do you make and/or grow in a professional capacity? Please describe in what ways you are a professional maker/growers

Have you ever been convicted of, or is prosecution pending for, a criminal offence in any country?

Have you ever been, or are you currently, on the Sex Offenders Register in any country?

If the answer is yes to one of the 2 previous questions, please provide us with additional information at foundationsacredplantmedicine@gmail.com

I agree

You may have skills and experience that you would like to share and that would be of benefit to the work of the FSPM. We welcome assistance in areas such as administration, advertising, technical support, web design and many other areas. If you would be interested do let us know

I would be interested in helping with the work of the FSPM on a voluntary basis

If yes, please provide information about the skills/experience you would like to share, along with days/times of availability

Please provide name, address & contact details of 2 people the FSPM may contact as referees

Please list my contact details on the FSPM online register

I would like my contact details to be made available to Full and Associate Members so that I can be kept informed of regional meetings

I would like to be included on the FSPM mailing list and be kept up to date with any relevant events, training, news or activities relating to the work of the FSPM

Please tick if simultaneously applying for membership in another category

Healing practitioners Priestesses and Priests

I understand membership is awarded at the discretion of the FSPM and that if I am ever in breach of the FSPM Constitution or the FSPM Code of Ethics then my membership may be revoked.

I confirm all the information I have provided in this form is true and accurate.