Membership category

transfer application form

Your name:

Your membership number:

What is an IOSH Technical member? What is an IOSH Certified member?

If you're a qualified and experienced
practitioner, you can move up to Technical
membership. This level recognises both the
qualifications and experience needed by
professionals working in a range of
operational health and safety roles.
Certified members have achieved a
recognised and relevant degree-level
qualification and have been operating in an
occupational safety and health role.

Please insert your health and safety qualifications

Awarding body Qualification name Date obtained Qualification level

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 |
1 www.iosh.co.uk
Please tell us about your health and safety responsibilities in your current and previous job roles.
Please note, we only require your health and safety responsibilities, all other responsibilities can be
omitted. Start with your most recent experience first.

When sharing your employment responsibilities, please use the action words below to describe
your role.

Action words Action word description

Apply To put into operation
Lead To guide and take responsibility for others
Support/assist To help with
Manage To hold the main responsibility of a function or to lead others on an activity
Produce/prepare To undertake an activity and develop an outcome
Carry-out/undertake To be responsible for completing an activity
Create/draft To develop or produce
Oversee To review others’ activities
Review To check others’ activities

Job title:

Organisation name:

End date (MM/YYYY): End date (MM/YYYY):

Activity Action word Description

(Activity you are (Which action word best (What do you do/how do you do it?)
involved in) matches your activity)

IOSH, The Grange, Highfield Drive, Wigston, Leicestershire LE18 1NN t +44 (0)116 257 3100 | 2
www.iosh.co.uk
Job title:

Organisation name:

End date (MM/YYYY): End date (MM/YYYY):

Activity Action word Description

(Activity you are (Which action word best (What do you do/how do you do it?)
involved in) matches your activity)

Job title:

Organisation name:

End date (MM/YYYY): End date (MM/YYYY):

Activity Action word Description

(Activity you are (Which action word best (What do you do/how do you do it?)
involved in) matches your activity)

IOSH, The Grange, Highfield Drive, Wigston, Leicestershire LE18 1NN t +44 (0)116 257 3100 | 3
www.iosh.co.uk