Fillable Student Membership application form Section one About you (Institute of Occupational Safety and Health)

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Student Membership application form Section one About you (Institute of Occupational Safety and Health)

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  • 82 check-boxes
  • 49 other fields

Country of origin: UK
File type: PDF

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BROWSE INSTITUTE OF OCCUPATIONAL SAFETY AND HEALTH FORMS

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Title* Mr Mrs Miss Ms Other
Forename(s)*
(This should match the proof of your student status that you provide us (see below).
Surname*
(This should match the proof of your student status that you provide us (see below).
Date of birth (DD/MM/YYYY)* / /
Gender* Male Female Other
If you have selected ‘other’ and you would like to provide us with additional information e.g. your gender identity or preferred
pronouns, please complete this box.
Contact phone no.* (Please include the area/country code)
Mobile phone no.
When would be the best time to contact you?
Email*
Current address*
Postcode*
Are you part-time student?* Yes No
University/course provider*
* Please ensure that all of the mandatory personal details and course details that you have provided are accurate.
If anything is unclear or incorrect, we will need to contact you, which will lead to a delay in the processing
of your application and possible refusal of Student Membership. Please provide your full address including
country and P.O Box number, if applicable. We will send your membership documents to your current address.
Part-time students: membership is just £50 for the duration of your course.
Course title
Start date (MM/YYYY) / End date
†
(MM/YYYY) /
† This should be the date you will receive your certificate. You will be allowed to remain a Student Member for
a maximum of three months after this date to give you enough time to convert your membership to the next
relevant grade; Associate, Technical or Graduate. Your Student Membership will end if you haven’t converted
your membership after the three-month period has passed.
Is this your first OSH qualification? Yes No
Student Membership
application form
Section one – About you (please use BLOCK CAPITALS)
01
Networking with peers is an important part of your development as an OSH practitioner or professional.
IOSH offers local and sectoral networks as part of your membership subscription. Our networks
provide a variety of activities, from meetings and seminars, to site visits and webinars – all designed
by volunteer committees to support your continued learning and development.
Please select a primary local network (branch or district) that you would like to be aligned with.
UK
Bristol and West
Chiltern
East Anglia
East Midlands
Edinburgh
Essex
Forth and Tay
Highlands and Islands
Humber
London Metropolitan
Manchester and North
West Districts
Central Lancashire
East Lancashire
North Staffordshire
and South Cheshire
Merseyside
Midland
Midland West District
Mid Shires
North East of Scotland
North Wales
Northern Ireland
South Coast
South Cumbria and
North Lancashire
South Downs
South East
South Midlands
South Wales
South West
Staffordshire
Tees
Thames Valley
Tyne and Wear
North Cumbria District
West of Scotland
West Wales
Yorkshire
Ireland
Ireland
Ireland North
Western District
Ireland Western
District
Ireland East
Ireland South
Ireland South
Eastern District
Worldwide
Caribbean
Hong Kong
Isle of Man
Oman
Qatar
Singapore
UAE
Section three – Networks
If you are currently working, you can provide your work contact details below. (optional)
Job title
Company name
Industry sector
Work phone no.
Work address
Postcode
Section two – About work
02
Student membership application form
Please tick this box to opt into receiving your copy of the bi-monthly IOSH Magazine by email,
free of charge.
Section five – How did you hear about us?
Please tell us where you heard about us:
course or qualification – please specify:
referral by current member – please give their membership number, if possible:
event – please specify:
internet search
social media – Facebook, LinkedIn, Twitter, YouTube
employer
leaflet or advertisement – please quote reference or title:
media coverage – television, radio or newspaper
invitation – please quote reference:
none of the above – please specify where:
freshers fair
Section six - IOSH Magazine
If you are a part-time student you will need to pay a one-off fee of £50 for the duration of your course.
Once we have processed your student membership application we will contact you for payment.
We can take payment over the phone by credit or debit card.
If you would like to pay by bank transfer, then please call +44 (0)116 257 3198
or email studentmembership@iosh.com
If you have any further application or payment queries, please contact our customer service centre
on +44 (0)116 257 3198 or email studentmembership@iosh.com
Section seven – Payment details
(Not applicable for full-time students)
Our groups cover a wide range of industries. If you would like to network with other OSH professionals
in an industry sector or find out more information about a specific industry, then have a look at our
groups below. As a member you can join as many groups as you like, free of charge. Just tick the
group(s) you’d like to join:
Railway
Retail and Distribution
Rural Industries
Sports Grounds and Events
Theatre Advisory Group
(Subsidiary of Sports
Grounds and Events)
Aviation and Aerospace
Broadcasting and
Telecommunications
Construction
Consultancy
Education
Environmental and Waste
Management
Financial Services
Fire Risk Management
Food and Drink Industries
Hazardous Industries
Health and Social Care
Offshore
Public Services
Section four – Groups
03
Student membership application form
Section eight – Your signature and data protection
Code of Conduct, Royal Charter and Byelaws
Please read our Code of Conduct and Royal
Charter and Byelaws. By signing this form, you
agree to be bound by the rules laid out in these
documents. We reserve the right to refuse
membership to, or cancel the membership of,
anyone who doesn’t meet the requirements of the
Code of Conduct and Royal Charter and Byelaws.
IOSH Privacy Statement
In accordance with the General Data Protection
Regulation, we will only use your personal data in
connection with your contract with us and so that
we can provide you with the agreed services.
As a member of IOSH, you’re agreeing to let us
contact the universities or colleges where you
gained your qualifications so that we can verify
the content and standards of the courses you
followed, if necessary.
From time to time, we use and pass limited
personal information to contracted third-party
agents to perform specific tasks on our behalf
(eg to promote and run our annual conference
and to publish and mail IOSH Magazine). To
provide you with membership services, we’ll
use your data to:
- let you know about member benefits
and ask for your views
- administer your membership record
- provide details of your membership category
and length of membership to prospective
employers who ask us for this information
- send you governance, financial
and other documentation
- send you mail from our subsidiary,
IOSH Services Limited.
Contact permission
Here at IOSH we take your privacy seriously
and will only use your personal information
to administer your membership account and
to provide the products and services you have
requested from us. However, from time to time
we would like to contact you with details of
other health and safety services and products
from IOSH and its contracted agents.
If you consent to us contacting you for this
purpose, please tick to say how you would
like us to contact you:
Post Email SMS
We only pass your details over to our third parties
to enable you to receive the full benefits of your
IOSH membership. We’ll always treat your personal
details with the utmost care and will never sell
them to other companies for marketing purposes.
Please sign and date your application to:
- show that you’ve read, understood and
accepted our Code of Conduct, Charter
and Byelaws and IOSH privacy policy
- confirm that the information you’ve
supplied is accurate.
Your signature*
Date*
We won’t
process your
application
without a
signature
and date
When you’ve completed this form, please email it, as an attachment and send it to
studentmembership@iosh.com or you can print the form and post it to customer service centre,
IOSH, The Grange, Highfield Drive, Wigston, Leicestershire, LE18 1NN, UK.
Please note we will also require you to send in proof of enrolment. This will need to be an official
letter from your university/course provider and include the qualification title and enrolment start
and end dates.
If you have any questions about your application please contact the customer service centre
by emailing studentmembership@iosh.com or phone +44 (0) 116 257 3198.
Updated
August 2020
04
IOSH, The Grange, Highfield Drive, Wigston, Leicestershire LE18 1NN, UK
t +44 (0)116 257 3100 www.iosh.com
PS0512.8/020620/PDF
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Student Membership application form Section one About you (Institute of Occupational Safety and Health)

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Completed 27 March 2021

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