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The Security Institute – Application for Student Membership

Student membership is available to anyone studying on a recognised full or part-time course in a security related subject.

When submitting this application please include proof of your student status ie: letter from university/course provider; student card etc.

Your first year’s membership fee (£50) must be submitted with this application.

SECTION 1: PERSONAL INFORMATION

Please print or type all information clearly, using a black pen. You may register more than one email address with us, but only one address for any occasional postal communications.

Surname       Forename (s)      

Previous Names(s)       Known as       Title      

Date of Birth       Place of Birth      

HOME ADDRESSYour home address is used to complete pre-membership checks. If you prefer all postal communication with the Security Institute to be sent to your HOME address, please tick here. (Double click box and select ‘checked’)

Address      

Town       Post Code      

County       Country (if not UK)      

Telephone      

ALTERNATIVE/BUSINESS ADDRESSYou can choose an alternative set of contacts for your post and email eg: Business, term address etc. Please complete all fields that are relevant. If you prefer all postal communication with the Security Institute to be sent to your ALTERNATIVE address, please tick here. (Double click box and select ‘checked’)

Company Name      

Nature of Business      

Job Title      

Address      

Town       Post Code      

County       Country (if not UK)      

Telephone       Mobile      

EMAIL ADDRESS (Mandatory)Preferred Email Address      

Alternative Email Address      

MENTORING PROGRAMMEThe Security Institute has a free Mentoring Programme for members, partnering them with a professional experienced in a relevant area of security, to provide guidance and advice on professional development, career choices and security issues. If you would like someone to contact you to discuss how to join the scheme, please tick here.

© Security Institute 2014Application for Student Membership

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The Security Institute – Application for Student Membership

SECTION 2: COURSE DETAILS

Course Title      

Course Provider      

Study Start/End Dates       End Qualification      

Tutor Name       Tutor’s Phone      

Tutor’s Email      

SECTION 3: DECLARATION

I am applying for student membership of the Security Institute. The information I have given in this Application is true to the best of my knowledge and belief. I understand that my Application may be declared invalid and any subsequent membership or affiliation may

be revoked if any of this information is found to be false, inaccurate or intentionally misleading. The Institute will not be liable for making any refunds in these circumstances.

I understand that the Security Institute may wish to verify some or all of the information provided and I hereby authorise the Institute or its appointed agents to perform reference checks as required.

I give my permission to the Security Institute to process, file and retain the information that I have provided in this application. I understand that should my membership cease, this information will be retained for up to 3 years from the date my membership expires.

If I am accepted into the Security Institute, I agree to be bound by its Standards, Rules and Ethics, Articles of Association and Regulations copies of which are available on the Institute’s website https://www.security-institute.org/About_Us/governance/company_info for the time being in force.

I undertake to advise the Institute of any changes to my personal contact details and professional circumstances.

I undertake to pay any dues promptly, and understand membership may be withdrawn if payment is not made.

DATA PROTECTION ACT 1998

The information requested in this form has been solicited to enable the Security Institute to process your application, to verify the information contained therein and to provide you with an ongoing membership service. Communications concerning governance together with our monthly eNewsletter are a core part of your membership and are essential in order that we can keep you informed about key Institute activities.

We would also like to send other information which we consider may be of interest to you and to enable you to gain as much as possible from your membership – this will include information on forthcoming events, requests for information to help us to improve our membership services and other relevant timely information which we consider may be of value to you. Please tick this box if you do not wish to receive these communications:

Our preferred method of communication is via email, however occasionally we may wish to send postal mailings. In order to do this efficiently we may seek to engage a company to undertake the mailing on our behalf. Please tick this box if you do not consent to the Security Institute disclosing your postal address to an engaged 3rd party for this purpose:

The Security Institute will protect the information which you have provided and will ensure that it is not disclosed to any individual or organisation not authorised to see it. The Security Institute’s full Privacy Policy can be found at: https://www.security-institute.org/privacy

Signed:       Date:      

Applications sent via email are deemed to have been signed once submitted to the Security Institute for processing.

© Security Institute 2014Application for Student Membership

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The Security Institute – Application for Student Membership

How did you find out about the Security Institute? (Please tick one)

Existing Member Exhibition/Event SyI Members’ Event

Editorial or Publication Website/Search Engine Training/Qualification

Via RCSP Employer Recommendation Other

SECTION 4: SUBMITTING YOUR APPLICATION

Please send your completed application (email or paper), including all attachments (scans or photocopies) to:The Validation Board RegistrarThe Security Institute1 The CourtyardCALDECOTEWarks CV10 0AS or info@security-institute.org

PAYMENT of your first year’s annual subscription fee (£50.00) must be submitted with your membership application. We accept payment by cheque, BACS, and credit/debit card (including AMEX).

The Membership Year runs from 1st of the month following membership confirmation, and annual subscriptions fees are payable on the anniversary of this date. Failure to pay annual subscription fees when required will invalidate membership.

PAYMENT CONFIRMATIONREMITTANCE ADVICE

I wish to pay my First Year’s Annual Subscription Fee of £50 by:

Cheque: This should be made payable to The Security Institute and sent to: 1 The Courtyard, Caldecote, Warwickshire, CV10 0AS

BACS: Please ensure that your name is quoted as a reference on the BACS details. Our bank details are The Security Institute, Account Number 83798879, Barclays, 22 The Borough, Farnham, Surrey, GU9 7NH, Bank Sort Code: 20-31-06. IBAN: GB33 BARC 2031 0683 7988 79

Credit/Debit Card Payment can be made online via our website http://www.security-institute-shop.org Payment is made at the time of purchase through PayPal, and you can instantly print out your own receipt. Alternatively you may complete the details below.

© Security Institute 2014Application for Student Membership

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Expiry Date                     Security Code                

Start Date (Maestro/Solo cards only                      Issue No (Maestro/Solo cards only           If preferred, please telephone through card information to our head office on 08453 707717 (within the UK) or +44 2476 346464 (from outside the UK)