Вы находитесь на странице: 1из 5

For office Reference

use only
Full June 15

FULL MEMBERSHIP AND


CHARTERED ENVIRONMENTALIST
(CEnv) APPLICATION FORM
Please read the guidance found in Guide to Full Membership of IEMA (MIEMA) and Chartered Environmentalist (CEnv) before
completing this application form. NB. In order to apply for Full Membership and CEnv you must be a member of IEMA.

Personal Details:
Title First Name
Surname Date of Birth
Membership Number (if already a member) Email
Full Employer/Organisation Name

If you are not currently a member of IEMA or any of your details have changed, please complete the sections below.
NB. All future correspondence will be sent to this address.

Correspondence Address
Town
County
Postcode
Country

Complete this section only if it is different to the Correspondence Address


Billing Address
Town
County
Postcode

Mobile Telephone
Home Telephone
Business Telephone
Job Title

Supporting Documents Checklist:


For your Membership application to be processed, please include 4 copies of the following:
A completed application form
Supporting Paper: no more than 2000 words
Full Curriculum Vitae: no more than 4 sides of A4
Witness statements, completed and signed by two witnesses
Colour copy of photo ID e.g. driving licence or passport

The Interview Assessment


Interview assessments for this level are normally completed using a webcam and audio setup. However, a face-to-face interview can
be scheduled, with all costs payable by the candidate.

I would prefer to have a face-to-face interview at my own cost


I have a registered disability and would like IEMA to contact me to explain interview assessment options.

IEMA has a policy to ensure no candidate is disadvantaged during assessment. If you have any special requirements that may affect
your application, please enclose details in a covering letter to accompany your application. Please note that you must disclose any
special requirements at the start of the application process. Anything not disclosed at this time cannot be relied upon later.

1
Membership and Registration
Tick Fee
Existing Member of IEMA applying for Full Membership/Dual/CEnv 415.00
I am a current IEMA Full Member and wish to achieve CEnv status 415.00
I am not a Member of IEMA and would like to join as an Affiliate and Full/Dual/CEnv 532.00
I have CEnv status through another professional body and wish to achieve IEMA Full
311.00
Membership and can then transfer my CEnv status should I require

Declarations

I confirm that I have read and understood the criteria and application guidance for IEMA
Full Membership and CEnv and believe I fulfil the requirements.

I understand that CPD is essential to maintaining my membership and will be required


on an annual basis.
By signing this form I declare that I have read and understood the Code of Practice for
IEMA and Society for the Environment and will endeavour to uphold these principles in
my professional capacity, and in order to maintain my IEMA Full and CEnv status.

Signature: Date:

By signing your name on this form, you confirm that the information supplied is complete and accurate and
you understand that your application or resulting qualification/membership may be withdrawn at a later date if
the information is found and proved to be false and/or misleading. Membership and registration fees are non-
refundable. Incomplete applications will not be accepted.

NEXT STEPS

1. Complete this form and supporting documents, ensuring you sign and date it and that the
required number of copies are included.

2. Return the form and supporting documents, in person, to an IEMA member of staff or
alternatively post it to the IEMA Membership Team at: IEMA, City Office Park, Tritton Road,
Lincoln. LN6 7AS UK.

3. Payment must be received in order to process your application. Please complete the
payment details section.

2
CODES OF PRACTICE
As a Full Member of IEMA I will: As a Chartered Environmentalist I will:

Uphold and promote the environment and sustainability Act in accordance with the best principles for the
profession; mitigation of environmental harm and the enhancement
of environmental quality;

Exercise honesty, impartiality, diligence and objectivity in


my professional work; Strive to ensure that the uses of natural resources are fair
and sustainable taking account of the needs of a diverse
society;
Support and promote sustainable action and challenge
environmentally unsustainable action;
Use my skills and experience to serve the needs of the
environment and society;
Work to, and promote, high standards and best practice in
the environment and sustainability profession;
Serve as an example to others for responsible
environmental behaviour;
Ensure that professional judgement is not influenced by
a conflict of interest and I shall make all relevant parties
aware where there is such a conflict; Not engage in conduct involving dishonesty, fraud, deceit
or misrepresentation or discrimination; and

Acknowledge my limitations of competence and not


undertake work which I know is beyond my professional Commit to maintaining my personal professional
capability; competence and strive to maintain the integrity and
competence of my profession.

Develop and maintain standards of professional


competence and knowledge through a combination of
training, learning and practical experience and through the
support of others;

In giving advice, make the relevant person(s) aware of the


potential consequences of actions; and

Endeavour to be an innovative, lateral thinker in the pursuit


of environmental improvement and sustainability.

Signature: Date:

3
Witnesses

Two witnesses are required to verify that the paper submitted is both a fair and representative
account of the candidates experience in relation to the criteria for Full Membership.

Witnesses cannot be the applicants IEMA mentor. Examples of a witness include line manager, colleague
and/or client.
One or both witnesses should have an environmental/
sustainability background and it is preferable but not Original copies of witness statements are preferred
compulsory if at least one is an IEMA Full and/or Chartered however scanned copies are accepted.
Environmentalist member.

By signing this witness statement you are confirming you have:

Verified that the supporting paper, CV and other information provided in this application is a
fair representation of the candidates skills and experience.

That you know the candidate in a professional capacity.

Witness one

Name
Job Title
Employer

Professional Qualifications
(e.g. MSc, MIEMA, CEnv etc.)
Relationship to candidate

Address

Telephone
Email

Signature: Date:

Witness two

Name
Job Title
Employer
Professional Qualifications
(e.g. MSc, MIEMA, CEnv etc.)
Relationship to candidate

Address

Telephone
Email

Signature: Date:

4
Payment Details:
Please tick your preferred payment method. Please note that fees are non-refundable. If you would prefer to pay for your
registration by credit or debit card over the telephone, please submit your application and supporting documents and tick the box
below. It is not necessary to make 4 copies of the payment details section. Receipts are automatically emailed once payment
has been taken.

I would like to pay over the telephone. Please contact me.

I would like to pay by Credit/Debit Card:


Mastercard Visa UK Maestro Visa Debit Visa Electron

Credit Card Information:

Card Holders Name and Initials Card Number


Start Date Expiry Date
Issue Number CVN (last 3 digits on
(if paying by UK Maestro) the back of your card)

Signature Date