Membership Application Form

Please complete this form, and click 'Submit' at the foot of the page. You will then be prompted to review completed details, before clicking 'Submit' for a SECOND TIME, at the foot of the review page.

Surname:
Other Names:
Title:
Company Name:
Date of Birth:
Age:
Honours:
Degrees & Qualifications:
Address:
Postcode:
Telephone No.:
Fax No.:
Email:


Disability
(If you are disabled please state the nature of the disability and any relevant further information in the space here):
Employment summary during last ten years in chronological order:
Category of Membership Applied For:


The following information is required as text for your entry in the list of members included on the SEC website (NB. be sure to include only contact information that you want to be published).
Surname:
Company Name (if any):
Other Names:
Address:
Postcode:
Specialisms: up to six words that summarise your specialist areas of work:
Telephone No.:
Mobile No.:
Fax No.:
Website:
Email:
Single paragraph of no more than 150 words describing your services. Suggested headings include: previous clients, and previous experience.
Your entry on the SEC website may also refer to:
  1. Two website links. Please insert any required links below:
    Link 1:
    Link 2:
  2. A curriculum vitae. If required, please attach a CV - as a Word doc only.
  3. Further information in a free-form format. If required, please attach further information as a Word document only.
Note: if you do not want to attach a cv or further information with your application this information can be added to the SEC website at a later date (of your choice).


Please supply the name and address of two people who would support your application for membership. Note that BOTH referees should have substantial knowledge of your professional work and, if possible, one should be a current (or retired) member of the society.

Name:
Position:
Address:
Postcode:
Telephone No.:
Email:
Name:
Position:
Address:
Postcode:
Telephone No.:
Email:
Ethnicity:

Applicants are requested to complete this part of the form on a voluntary basis. Information is used purely for maintaining a profile for the Society as a whole.

White:

Mixed:
Asian/Asian British:

Black/ Black British: