QSi Application

 QSi Application Form..........Notes for Guidance

Please ensure that the application form is completed in full online. There are now two methods of payment for membership, prospective members can either pay online or send a printout of the remittance slip with a cheque for the appropriate level of membership required.

The QSi Accepts the following payment methods via Secure Trading      

In the event of Application Form submission problems, the completed application form may be submitted by Fax to Suzanne Cash on 01606 786698.

 Fields marked * are mandatory.

Location Details
*Area of Residence

* NOTE - you must select an area before completing the remainder of the form
Personal Details
* Surname :
* Forenames :
* Home Address (please complete in full):
* Email Address :
* Tel: Home :
*Country of Residence
Mobile Tel :
Qualifications :

Company Details
Company Name :
International Region :
Area (UK & Ireland only):
Company Category :
Company Email :
Company Telephone :
Company Fax :
Company Web Address : (must begin http://)
Some companies have registered for corporate discounts. If you know your company and discount code please enter them below
Corporate Discount : (select your company)
Corporate Discount : (enter your code)

Employment History
Complete each column listing jobs in reverse chronological order starting with your current employment.
Date fromDate toEmployer DetailsJob Title & Responsibilities
MonthYear MonthYear

QualificationsYear of Attainment
Professional : Year :
Professional : Year :
Professional : Year :
Academic : Year :
Academic : Year :
Academic : Year :
Other/Experience : Year :

Reference 1
* Name :
* Professional Status :
* Business Address :
* Tel :
Email :
Reference 2
* Name :
* Professional Status :
* Business Address :
* Tel :
Email :

Applicant's Declaration
I hereby apply online for membership of the QSi. As a Member of the QSi I undertake to comply with the Membership Rules and Regulations.
I declare that the statements on this form are true and I understand the references may be contacted.
* Name :
* Date (dd/mm/yyyy):
* New Membership:
The QSi processes member information in accordance with the Data Protection Act 1998. A copy of the full QSi Privacy Policy is available on request. Occasionally, where there is judged to be benefit to members, appropriate data may be passed to a third party.

 If you wish to be excluded, please tick this box.
 If you would like your company to be included in search results and listed in our member directory, please tick this box.
Discount Code