Membership

application form
About you (please use BLOCK CAPITALS)

Title Dr Mr Mrs Miss Ms Other

Forename(s)*

Surname*

Contact phone no.* Mobile phone no.

Email*

Date of birth DD/MM/YYYY* / /

Gender Male Female Other

Home address*

Postcode*

Job title

Company name

Industry sector

Work phone no.

Work address

Postcode

We will send your membership documents to your home address.

We will send your annual subscription renewal notice by email.

If you prefer a printed copy of your renewal, please indicate the address we should send it to.
Home   Work

*Please ensure all mandatory fields are completed.

Upgrading your IOSH membership
All members join IOSH as Affiliate members. If you would like to check whether you are eligible
to upgrade your membership, please provide us with the following information.
• A good quality copy of the certificate or diploma of the qualification you have completed.
Please do not send your original certificates.
• Your CV, demonstrating your health and safety experience and showing how long you have
worked in the profession.
Once you have become a member you will have an online CPD record that you can update.
We will request a CPD development plan before we make an upgrade recommendation.

Networks
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 Ireland
Bristol and West Midland Ireland
Chiltern Midland West District Ireland North
East Anglia Mid Shires Western District
East Midlands North East of Scotland Ireland Western
District
Edinburgh North Wales
Ireland East
Essex Northern Ireland
Ireland South
Forth and Tay South Coast
Ireland South
Highlands and Islands South Downs
Eastern District
Humber South East
London Metropolitan South Midlands Worldwide
Manchester and North South Wales Caribbean
West Districts South West Hong Kong
Central Lancashire Isle of Man
Staffordshire
East Lancashire
Tees Oman
South Cumbria
and North Lancashire Thames Valley Qatar
North Staffordshire Singapore
and South Cheshire Tyne and Wear
North Cumbria District UAE
Merseyside
West Africa Division
West of Scotland
Accra (Ghana) Region
West Wales
North Central (Abuja)
Yorkshire
Region
South South
(Port Harcourt) Region
South West (Lagos) Region

As a member, you can join as many groups as you like, free of charge, from the following list.
Just tick the group(s) you’d like to join.

Aviation and Aerospace Financial Services, Logistics and Retail

Broadcasting and Professional Services and Offshore
Telecommunications Facilities Management
Public Services
Construction Fire Risk Management
Railway
Consultancy Food and Drink Industries
Rural Industries
Education Hazardous Industries
Sports Grounds and Events
Environmental and Waste Health and Social Care
Theatre Advisory Group
Management
 Please tell us where you heard about us:
referral by current member – please give their membership number, if possible:
course or qualification – please specify:
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:

Joining fee £216.00

All members receive IOSH Magazine by email. If you’d like to have IOSH Magazine posted
to you in hard copy, please tick this box.

Your membership lasts one year from the date we accept your application. We can’t accept a direct
debit for your first payment, but if you’d like to pay by direct debit in future years, fill out the
mandate below.

If you want to pay by debit or credit card, please go to www.iosh.com/join and join online.
You’ll immediately become an Affiliate Member and get access to all the benefits of membership.

If you’d like to pay by bank draft, call +44 (0)116 350 0800 or email csc@iosh.com.

If you want to pay in euros, please call +44 (0)116 350 0800 or email csc@iosh.com
for more information.

Please note: the Direct Debit (DD) mandate below is for UK members only.
The DD mandate cannot be completed electronically. Please print out the entire application form and fill in the DD mandate
using a ballpoint pen. Either print out and post the form to Customer Service Centre, IOSH, The Grange, Highfield Drive,
Wigston, Leicestershire, LE18 1NN – or scan and email it to csc@iosh.com.

Instruction to your bank or building society to pay by direct debit

Please fill in the form using a ballpoint pen and send it to IOSH, The Grange, Highfield Drive, Wigston, Leics, LE18 1NN.

Name and full postal address of your bank or building society Originator’s identification number 7 6 7 1 1 4
To: The Manager, Bank/Building Society
Please tick
Reference
one box
number
Personal account
Business account
Postcode Instruction to your bank or building society: Please pay IOSH direct debits
from the account detailed on this instruction subject to safeguards by the direct
debit guarantee.
Address of account holder if different from above I understand that this instruction may remain with IOSH and, if so, details will
be passed electronically to my bank/building society

Signature(s)
Postcode

Name(s) of account holder(s)

Bank/building society account number Branch sort code

Date
Banks and building societies may not accept direct debit instructions for some types of account. Institution of Occupational Safety and Health • The Grange • Highfield Drive • Wigston • Leicestershire • LE18 1NN • UK

This guarantee should be retained by the Payer The direct debit guarantee
• This guarantee is offered by all banks and building societies that take part in the direct debit scheme. The efficiency and security of the scheme are monitored and protected by your own bank or building society • If the amounts to be paid
or the payment dates change IOSH will notify you 10 working days in advance of your account being debited or as otherwise agreed • If an error is made by IOSH or your bank or building society, you are guaranteed a full and immediate
refund from your branch of the amount paid • You can cancel a direct debit at any time by writing to your bank or building society. Please also send a copy of your letter to us.
 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
We won’t
• administer your membership record
process your
• provide details of your membership category
application
and length of membership to prospective
without a employers who ask us for this information
signature and
date
Your signature*
When you’ve completed this form, scan and email it to csc@iosh.com or post it to
Customer Service Centre, IOSH, The Grange, Highfield Drive, Wigston, Leicestershire, LE18 1NN, UK.
Updated If you have any questions about your application, please email csc@iosh.com
April 2023 or phone +44 (0)116 350 0800
• 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.
Date*
PS0385/210820/PDF