Supported Membership Scheme

This form is for individuals who have been granted refugee resettlement status in the last 12 months to apply for a free Better Health Centre (Off-Peak) membership for a fixed six-month period.

The applicant or sponsor will need to supply the relevant personal details and proof of eligibility for EACH applicant (if multiple applicants, please submit one form per applicant).

For information about how to apply for supported memberships in Belfast, please click here

 

Please indicate two preferred options for lesson day, time and level. If lessons are not available at the preferred centre, or on the preferred day or time, the application will be rejected and another request must be submitted for alternative options. Please check for lesson availability here before submitting options below.

Option 1

Option 2

In order for us to process your application for a six month membership, you will need to provide the following proof of eligibility:

  • Refugee Settlement Residence Permit

The proof must be dated within the last 12 months from the date you submit the application or it will not be accepted.

If incorrect proof is provided, your application will be automatically rejected and you will need to reapply providing correct proof.

Upload proof

Either scan the Residence Permit or take a photo of it using a smartphone camera or digital camera. The front of the permit must be visible on the scan or photo. You must save the photo as one of the following file types: PNG, JPG or JPEG. Most smartphones and digital cameras automatically save photos as one of these file types.

Select Choose file to find your image for upload. Once the image has been chosen, select Upload File. If you have more than one file to upload, repeat the process until all files have been uploaded. Once complete, select Done Uploading Proof, review the Terms and Conditions and select Submit. You need to submit at least one file to submit this form.

This form does not accept PDF file uploads. Max size 10MB.