Less than 100 Employees

Application Form for Under 100 Employees

Please complete the details requested in the Application Form below and click 'submit'. Follow this link to view our Fees for the range of services we can provide.

**Please note: your application will go forward to and be subject to approval by, the Scottish Engineering Executive Committee.**
Company Name (*)	Please enter your Company Name
Company Address (*)	Please enter your Company Address
Company Post Code (*)	Please enter your Company Post Code
Main Telephone No. (*)	Please enter your Main Telephone Number
Main Fax No. (*)	Please enter your Main Fax Number
Main Email Address (*)	Please enter your Main Email Address
Description of Main Business	Invalid Input
Business Sector (*)	Please select your Business Sector from the list
Name of Parent/Holding Company (if any)	Invalid Input
Country of Registration	Invalid Input
	Basic Membership
Total Number of Employees (*)	Please enter the Total Number of Employees
Additional Sites Location	Invalid Input
	Select Membership Services required. You must take at least one of the following:
Membership Services Selection (*)	Service Package Telephone Advisory Service Employment Tribunal Service Health and Safety Service** You must pick at least one Service from the list
	** Your company retains its status as the competent person under the Management of Health & Safety at Work Regulations.
	Correspondence
	Routine correspondence should be addressed to:
Name (*)	Please enter a Name for correspondence
Position
Direct Phone No. (*)	Please enter a Direct Telephone Number for correspondence
Direct Fax No.
Direct Email Address (*)	Please enter an Email Address for correspondence
	Chief Executive correspondence should be addressed to:
Name (*)	Please enter a Name for correspondence
Position
Direct Phone No. (*)	Please enter a Direct Telephone Number for correspondence
Direct Fax No.
Direct Email Address (*)	Please enter an Email Address for correspondence
	Health, Safety and Environment correspondence should be addressed to:
Name (*)	Please enter a Name for correspondence
Position
Direct Phone No. (*)	Please enter a Direct Telephone Number for correspondence
Direct Fax No.
Direct Email Address (*)	Please enter an Email Address for correspondence
	Lifelong Learning correspondence should be addressed to:
Name (*)	Please enter a Name for correspondence
Position
Direct Phone No. (*)	Please enter a Direct Telephone Number for correspondence
Direct Fax No.
Direct Email Address (*)	Please enter an Email Address for correspondence
Declaration	We agree to comply with the Constitution of Scottish Engineering and in particular to give six calendar months written notice in the event of resignation or withdrawal from services. We also agree to submit a Mandate for the payment of fee by Direct Debit. You must check this box to confirm you comply with the Constitution of Scottish Engineering.
	Please note: your application will go forward to and be subject to approval by, the Scottish Engineering Executive Committee.
Name (*)	Please enter your Name
Position
Direct Phone No. (*)	Please enter your Direct Telephone Number.
Direct Fax No.
Direct Email Address (*)	Please enter your Email Address.
Date (DD/MM/YYYY) (*)	Please enter a date in DD/MM/YYYY format