Canada's National Association

Committed to developing highly trained reflexologists
since 1976
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2004 Membership Fees

  1. Certified Membership Fee: $162.00 (includes GST)
    Breakdown:
    • $107.00 (includes GST)
    • RAC Improvement Fee: $55.00

  2. Student Membership Fee: $107.00 (GST included)
  3. Associate Membership Fee: $107.00 (GST included)
Please renew as soon as possible.

    Section 1 - Mailing Address
    Application Type* Renewal
    Member Type* Certified
    Associate
    Student
    Member No
    Certificate No
    Preferred Language* English French
    Other
    First Name*
    Last Name*
    Address*
    City*
    Province
    Country*
    Postal Code*
    Business Name
    Home Phone*
    Work Phone
    Cell Phone
    Work Fax
    Email
    Website
     
    Section 2 - Referral List Information
    Note: The following information is that which you want the public to have. The ability to be registered is only offered to RAC certified reflexologists in good standing.

    I confirm that I am RAC certified and I wish to have my name given out as a referral:

    Please complete all fields in this section:
    Allow Referrals* I Agree I Disagree
    Nearest Intersection
    Referral City
    Referral Province
    Referral Fields Work Phone
    Home Phone
    Cell Phone
    House Calls Yes No
     
    Section 3 - Demographic Information
    Note: The following information will only be used by the office for gathering data for medical/dental and other group insurance discount programs.
    Age Group 18-25 26-30 31-44
    45-54 55-64 65+
    Gender Female Male
    Marital Status Single Married
    Children Under 25
    Formal Education High School
    Some Post Secondary
    College Diploma
    University Degree
    Post Graduate
    Practice Frequency < 20hrs 21-30hrs
    30hrs+ per week
    Treatment Charge < $30 $30-$50
    $51+ per visit
    Practice Location
    Other Modalities
    Which products/services do you wish you could purchase at a group discount?
    Group Discounts
    Wrap
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    Section 4 - Comments & Suggestions
    Comments
    Wrap
    Enlarge
     
    Section 5 - Payment Details
    (Payable in Canadian funds only please)
    Payment Method* Visa Master Card
    Amount*
    Name On Card*
    Card Number*
    Expiry Date*
     
    Section 6 - Contact Information Release
    By submitting the information contained in this form as a Certified member of the Reflexology Association of Canada; I hereby provide my permission for my contact information - including my e-mail address - to be added to the RAC Member and / or Teacher online referral directory. I acknowledge that my contact information will only be displayed on the RAC referral system as long as I am a certified member in good standing. I agree to contact RAC if my e-mail address changes in order to ensure this system is current.
    Acceptance I Agree I Disagree

    Membership

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