Office use only Office use only
Academic: Academic:
Work: Work:
Total: Total:
Delete as appropriate:
Member / Associate / Referral Member / Associate / Referral
Signature: Signature:
Application for IES Membership
Surname Forenames in full
(BLOCK LETTERS)
DELETE AS NECESSARY: Prof Dr Mr Mrs Ms Miss
Home address Date of birth
Home Email
Home Telephone
Mobile Telephone
Office address Job Title
Work Email
Office Telephone
Referees: Names, addresses, positions and telephone numbers of two referees must be given. They need
not be Institution members but should be able to give information on the applicants standing and
professional experience.
1: 2:
Summary of career (in chronological order) AND send a current CV
From To Career details
1
Qualifications and awards - Photocopies of the awarded certificates should be enclosed
Date Degree/qualification University/College
Membership of other professional bodies
Date Designated grade Professional body
Additional details may be given on a separate sheet.
In accordance with the Data Protection Act, permission is required to hold all personal data in electronic
format.
I agree to my name, contact details, job title and organisation being stored in an electronic format for IES
mailing purposes. Your details will never be passed on to a 3 rd party without your express permission.
I certify that the information given on this form is accurate and I apply for membership of the Institution of
Environmental Sciences. I agree to be bound by the Rules, Regulations and Constitution of the IES as
amended from time to time (see www.the-ies.org/members_documents) and to maintain with the IES a
registered email address.
Signature Date
The Application Form should be forwarded to: Applicant Check List:
Ticked data protection box
Institution of Environmental Sciences
3rd Floor Enclosed current CV
140 London Wall
London Enclosed 25 Admin fee
EC2Y 5DN
Included copies of relevant graduation certificates
or scanned and sent to info@the-ies.org
Application forms must either be accompanied by a cheque for 25 to cover administration
expenses (non-refundable) payable to Institution of Environmental Sciences or call
+44 (0)20 7601 1920 to pay by credit or debit card.
Your application will be reviewed by the IES Application Review Panel (ARP) made up of IES Council Members.
This process on average takes approximately one month. You will be notified as soon as the decision has
been made.