Membership category

transfer application form

Your name:

Membership number:

Part A: Your post-18 qualifications

Qualification levels should be based on a National Qualifications Framework or formally recognised within a
country’s education system.

Please start with your most recent qualification first.

Institution/awarding Qualification name Date obtained Is your qualification Qualification level

body accredited?
Part B: Your safety and health experience
Please tell us about your Health & Safety responsibilities in your current and previous job roles. Please
note, we only require your Health & Safety responsibilities, all other responsibilities can be omitted. Start with your
most recent experience first.

How many years of safety and health experience do you have?

Job role:

Organisation name:

Start date: End date:

Key safety and health responsibilities in your role:

Job role:

Organisation name:

Start date: End date:

Key safety and health responsibilities in your role:

Job role:

Organisation name:

Start date: End date:

Key safety and health responsibilities in your role:

Please provide evidence of your qualifications by sending copies of your certificates and transcripts with this
form to PDS@iosh.com. Do not send certificates for courses that are less than 10 days in duration.

We will assess your application and let you know the result within six working weeks of receipt

IOSH, The Grange, Highfield Drive, Wigston, Leicestershire LE18

1NN t +44 (0)116 257 3100 | www.iosh.co.uk

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