Member Application

The below information is necessary so we have the right information about you for our membership database, ensuring all details on the membership card are correct and we can contact you without delay.

Fields marked with an * are required.

About Your Interests

It is important as a charity that we learn more about your interests and requirements. This means we can always make improvements to our supports and services, based on what you, the family carer wants and needs.

Along with the above areas of interest, we will provide you with our quarterly Take Care Newsletter and contact you in relation to our annual AGM and National Conventions.

Please note as a charity, it is more economical for us to connect with you via email or text, so please keep this in mind when selecting the below. It is also more environmentally friendly. We also promise not to flood you with communications and will only be in touch about items of interest.

About the person(s) you are caring for:

Please note, where the cared-for person has the capacity to provide consent, please ensure they have agreed to the disclosure of their contact details and information.

* Please note this form can reference up to 3 cared for persons only. If you need another cared for person added to the card, please email membership@familycarers.ie immediately after your application.

Cared For Person One Details

In Case of Emergency Details:

In the event of MY accident/illness, please contact the number below as I care for someone, who in my absence may need assistance: -Please note this is someone alternative to you.