Membership application form Please enable JavaScript in your browser to complete this form. - Step 1 of 4Applicant InformationThis information is required to enter you into our database if your application is accepted.Title *Name *FirstMiddleLastPost nominals (Civil and military only)Email *Phone Number * If you have a proposer and seconder, please provide their names. Name of ProposerProvide the name of your proposer if applicable.Name of SeconderProvide the name of your seconder if applicable. If you are applying to be an Apprentice, please provide the details of a parent. Apprentice Parent nameFirstMiddleLastApprentice Parent phone numberApprentice Parent Contact emailParental AgreementI agree to the terms below.I understand the my child will be Apprenticed for 4-5 years to a Liveryman of good standing and that we will both need to attend an admission ceremony at the Hall on a date to be advised but usally at 5pm in the afternoon. WCSIM comply with safeguarding guidelines. Briefly explain your reasons for wanting to join the Livery *Please provide a link to an online profile if you have oneDate of Birth (dd/mm/yyyy) *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Home AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeWork AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAre you a Freeman of the City of London? *NoYes - please provide date belowIf you are Free of the City please provide the dateMembership of other Liveries - please stateQualification/Discipline summary e.g. BSc Engineering, PhD (please put comma between items)Membership of professional bodies e.g. InstMC, IoP, RSChemAreas of interestArtificial IntelligenceAstronomyAutomation & ControlAutomotive engineeringBiologyBio-medicalChemistryCNC machiningComputingCryogenicsData miningDefenceDesign EngineeringElectronicsElectrothermal engineeringEngineeringEntrepreneurshipEnvironmental instrumentationFibre opticsFuelGeographyHealthcareHearing technologyHeat exchangersHistory of scientific instrumentationHydrographyInternet of ThingsInventingMachine learningMarine EngineeringMaterials ScienceManagement buy-outsMathsMechanical engineeringMedical instrumentationMembrane technologyMensurationMetal machiningMicroscopyModellingNanotechnologyNon-exec rolesNuclearOpthalmologyOther InstrumentationPharmaceuticalPhysicsQuantum PhysicsRoboticsSemi-conductorsSensorsSoftwareSpaceSTEM educationSustainabilityTelecommunicationsTransportVenture CapitalOtherOther interestNextDemographicsWe like to monitor our diversity so it would be helpful to know the following.Gender--- Select Choice ---ManWomanOtherPrefer not to sayOther genderEthnic group in alphabetical order (using 2021 census classification 8a)Asian, Asian British or Asian WelshBlack, Black British, Black Welsh, Caribbean or AfricanMixed or Multiple ethnic groupsMixed or Multiple ethnic groupsWhite: English, Irish, Scottish or WelshWhite: Gypsy or Irish Traveller or RomaOther ethnic groupOther ethnic groupNationalities held (please seperate multiple nationalities with a comma)The Livery & YouThis section will help us learn a bit more about your interest in the Livery.How did you hear about us? (Select all that apply) *From a current or past memberAttended a Livery eventReceived an award from the LiverySearch engine results whilst looking Livery CompaniesI want to progress as a memberWebsiteSocial MediaOtherIf applying for Livery please name two members of the Livery who propose and second your applicationIf you do not know anyone in the Company please put none and we will contact you to arrange a meeting.Are you close to any of the following places? (we have local Hubs)ManchesterLondonOxfordCambridgeCardiffBristolWhat connection have you had with scientific instruments during your career? (Choose as many as appropriate)Manufacture of scientific instrumentsSales of scientific instrumentsStudent of scientific instrumentationScientifically qualifiedUser of scientific instrumentsAssociated with the craft of scientific instrumentsNextWhy are you interested in joining the Livery? (Select all that apply)Gain New KnowledgeMake Unexpected ConnectionsGain Interdisciplinary knowledgeMeet Fellow ResearchersMeet Likeminded peopleMake New FriendsAttend Formal DinnersHave opportunity to dress upOtherThe Livery operates through members volunteering their skills. What would you like to do? *Mentor ApprenticesBe active in Committee meetingsOrganise local Hub eventsEncourage people to become membersPromote the Company on Social mediaOrganise Special Interest GroupsGet inolved with wider City activitiesOtherPlease provide a CV and proof of identity document e.g. birth certificate, passport Drag & Drop Files, Choose Files to Upload You can upload up to 2 files. Any document provided through this field will be password protected and only be accessible to those processing membership applications. The files will be deleted once verification is complete.Agreement *I agree to the terms below.I understand that if my application is accepted, I will be expected to participate regularly, pay an admission fine and annual dues called quarterage. Data Protection *I agree to the terms below.I agree to my name and contact details being added to the membership directory which is open to all members. In line with the General Data Protection Regulation of May 2018, I agree that my email address and mobile number can be used for communication from the Company for the purposes of advising members of Livery and associated activities. The Company will not divulge or sell your details to any other organization. A copy of the WCSIM Data Privacy Policy is available on our web site.Photographs *I agree to the terms below.I agree to appearing in photographs taken at Company events that may be used for publicity purposes only (both print media and online).NextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit Share this: Share on X (Opens in new window) X Share on LinkedIn (Opens in new window) LinkedIn
