Consultant Membership Application

Membership of the Association is generally open to Consultants in hospital practice who are

Holders of the Common Contract; or
Who are eligible to hold a HSE structured public appointment; and
Who are either registered on, or eligible to be registered on, the Specialist Division of the Register of Medical Practitioners or the Register of Medical Specialists as maintained by the Irish Medical Council.

Certain exceptions and other rules apply and further details can be found in the Rules of Association here.

The fee for Consultant membership is €700 per annum, payable by direct debit mandate at €58 per month, online by credit card on an annual or monthly basis, or by cheque.

Membership Application/Renewal

Please note, fields marked with * must be completed

First Name*

Last Name*

Email for receipt*

Date of birth

Telephone No

Mobile No*

Preferred Mailing Address*

Gender

Specialty*

Sub Specialty

Hospital*

2nd Hospital

3nd Hospital

Specialist register*

Medical Council Reg No

Buckley*

2008 Contract*

2023 Contract*

Permanent*

Full Time Private Practice*

Locum*

Academic (fulltime) specify Buckley Category, 2008 Contract Type or 2023 Contract

Preferred method of payment

Direct Debit Mandate

Your account number - IBAN *

Your Bank Identifier Code - BIC *

Type of Payment

Irish Hospital Consultants Association
Heritage House
Dundrum Office Park
Dublin 14, D14 C2R2

Creditor Identifier:- IE18SDD300311

Note: Your rights regarding the above mandate are explained in a statement that you can obtain from your bank.Direct debits will be presented on the 25th or the next working day thereafter of every month Please return this mandate to the Creditor (IHCA).

I accept the terms & conditions *

Card Number*

Card Expiry*

Year*

CVV2/CVC2*

Name on card*

Please tick to indicate you have read and understand our Privacy Policy, in relation to how we treat your personal data and accept the terms & conditions *

A PDF of the Direct Debit Mandate can be downloaded here and returned by emailed to info@IHCA.ie. If you would like to pay your annual membership fee by cheque please email info@ihca.ie for details or attached the cheque with your application form and send to: Irish Hospital Consultants Association, Heritage House, Dundrum Office Park, Dundrum, Dublin 14, D14 C2R2, Ireland.

Consultant Membership Application

Membership Application/Renewal

Direct Debit Mandate

Join the IHCA