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APPLICATION FOR MEMBERSHIP

If you require assistance or advice, please telephone Head Office on 0191 422 0088

or e-mail info@instituteofwater.org.uk.

 

PERSONAL INFORMATION
Title *   Home Address *
Firstname(s) *    
Preferred Name    
Surname *    
Date of Birth *    
Gender *    
      Postcode
Correspondence
Address (if different
from above)
      
Postcode    
Employer *   Job Title
Work Tel No.   Home Tel No
Mobile Tel No   Email
Department *      
Are you classified as a manager?          
Length of time in industry *      

AREA*
Members are entitled to attend all Institute of Water events, details of which can be found on
www.instituteofwater.org.uk. You will receive direct notification of events in your selected
area(s). Please indicate the local area where you would like to be registered. You
can register with more than one area if you choose but this will incur a 5 pounds
charge per additional area. (Mark your first choice with 1 and additional areas with 0).
Eastern Midlands
Northern Northern Ireland
Scotland South Eastern
South Western Wales
Overseas    

WHY HAVE YOUR JOINED THE INSTITUTE OF WATER?
Number top 3 choices 1-3
Events Learn more about the industry
Networking Social Benefits
Professional Development Other. Please state  

HOW DID YOU FIND OUT ABOUT THE INSTITUTE OF WATER?
Number top 3 choices 1-3
Advert/Press Employee/Colleague
Event/Presentation Website
Word of Mouth Other. Please state 

Please provide the name of the Institute of Water member who

introduced you to the organisation (if applicable)

      

Would any of your colleagues like to hear about the Institute of Water?

If so please provide contact details

      

QUALIFICATIONS
Academic Qualifications (if applicable, please list top 3)
Course Title    
Grade / level    
Date Awarded (mm/yy)    
Course Title    
Grade / level    
Date Awarded (mm/yy)    
Course Title    
Grade / level    
Date Awarded (mm/yy)    

Membership of
Professional Bodies and any Professional Qualifications

      
       
       
Registration as Chartered Environmentalist, Chartered Engineer,
Incorporated Engineer of Engineering Technician is available to
Institute of Water members who satisfy the relevant criteria.
Please send me information on:
Chartered Engineer (CEng) Chartered Environmentalist (CEnv)
Incorporated Engineer (IEng) Corporate Membership
Engineering Technician (Eng Tech)