When you have completed the form please return it to:
The British Psychological Society
St Andrews House
48 Princess Road East
Leicester LE1 7DR
Who is this form for?
This application form can be used by candidates with qualifications and experience undertaken outside the
UK who wish to apply for Chartered membership of the Society. It is also possible to apply for membership of a Division.
Will my details appear on your website?
Anyone admitted to Chartered membership will appear on our online List of Chartered members allowing people to check your Chartered Status with the Society. The standard format is for the list to show your name and address, the form enables you to specify which address you are happy to be made public.
Should you not want any address to appear on the list please tick No in the Contact address field and leave the Chartered member list address field blank.
Do I have to send in my certificates?
You should provide copies of your psychology qualifications. Where applicable, transcripts (a list of subjects, and grades, you have undertaken) are required for All non-UK qualifications. If you are
Registered/Licensed outside the UK please submit a copy of your most recent registration/licensing certificate.
Translations are required for any documents not in English. We will not usually require original documents.
However, we do reserve the right to request originals.
If your name differs from that on your certificates/transcripts, etc. please provide evidence such as a copy of your marriage/partnership certificate, deed poll certificate, etc.
For current members there should be no need to resubmit documents for qualifications the Society has seen previously.
Some candidates will also need to attach additional information. For example, if you are applying on the basis of a research PhD in psychology you should attach a copy of the abstract and give details of who the supervisors and external examiners were.
Will work experience in the UK be considered?
We can only consider work experience gained outside the UK. This work needs to have been as a psychologist and carried out under regular supervision. It is often useful to include a CV or statement to detail the type of work and frequency of supervision.
Who can propose my application?
If you do not know two Chartered members of the Society who can comment on your training/experience outside the UK please give the names and contact details of two psychologists, one of whom should be able to confirm the details of your professional training and one who will be able to comment on your professional work following training, it is assumed they will be from outside the UK. Blank reference forms are available at the end of this document for your proposers to complete; completed reference forms may be submitted with the application. Please note that unless instructed otherwise the Society will write for references for any application received without references.
Oct 2014-09-25

How much do I need to pay?
You will need to submit the relevant subscription and any processing fees with your application. The total amount due will vary depending on whether you are applying to join the Society, upgrade current membership and/or join a Division. Full details of all of the rates and fees are on page 5 of this document.
How long does the application process take?
Some applications may have to be assessed/approved by external advisors to the membership team.
From receipt the average time for an application to be completed is 5 weeks.
Why should I apply for membership of a Division as well as Chartered membership?
By joining a Division you receive a more relevant membership experience. Division members receive regular newsletters from the Division, are informed of relevant events or conferences and can keep up to date with developments in their discipline.
Can I email the form to the Society?
Sorry, we cannot accept an email application. The application form must be signed so you will need to print this form off and post it to the Society’s Leicester office with confirmation of your qualifications.
Do you keep paper record of my application?
Your application information will be input to, and held in, our secure electronic database. We will not retain paper record of your application, certificates, etc. this will be securely destroyed within two weeks of your application’s approval, withdrawal or expiration of the time period to lodge an appeal.
Queries e: applications@bps.org.uk
t: +44(0)116 252 9911

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
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Please complete using BLOCK CAPITALS and black ink
Title (please circle) Mr Mrs Miss Ms Dr Professor No Title Other
Surname
Forenames
Previous surname
(if applicable)
Date of birth
BPS membership number (if known)
Approx lapse date if you are rejoining
Contact address
(Where no Chartered
Member List address is entered, this address will be available to the public unless otherwise indicated below)
Postcode
This address to be made public?
Email address
Mobile telephone
Yes

No

Chartered
Member List address
(this address will be available to the public – typically your work address)
Postcode
Daytime telephone
Fax number
- Applicants must include documentary proof of qualifications
Title and classification of qualification
Name of awarding University or Institution Start date
Date of award or expected completion e.g. BSc Hons Psychology UNISA Feb 2002 May 2006
- Please list the principal appointments held OUTSIDE THE UK since obtaining qualifications in psychology (continue on a separate sheet if necessary). It is often useful to include a CV.
Job title/occupation Employer Date from To
-
Please list below any registration or licensing you hold or have held
Name of registration/licensing authority Grade of registration/licensing Date from To

- You should not send your form containing payment card details to your referees. If paying by card the card details should be entered after your referees have seen your form.
Please give the names and contact details of two psychologists, one of whom should be able to confirm the details of your professional training and one who will be able to comment on your professional work following training.
Name:
BPS number (if applicable):
Address:
Name:
BPS number (if applicable):
Address:
Email:
Fax:
Email:
Fax:
I declare that the information given in this form and any supporting documentation is true and accurate. I have read the Member Conduct Rules and undertake to abide by and operate within them at all times. The Member Conduct
Rules are ava ilable on the Society’s website www.bps.org.uk
Signed: Date:
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E-mail addresses may be used by the Society to communicate with you instead of by post in matters relating to your membership. Please tick if you also wish to receive messages from carefully selected third parties.

We may also from time to time send material by post from carefully selected third parties. If you do not wish to receive this, please tick here.
The Society will not sell or give your personal details to any third parties without first seeking your permission or we are legally instructed to do so under UK law.
The appended subscription and application fees sheet has details of the amount you need to pay. Please include a cheque made payable to The British Psychological Society for the relevant fees or confirm the amount and give your debit/credit card details below. Unfortunately payment for this application cannot be done by Direct Debit.
I enclose a cheque for
or please charge my Credit/Debit card
Name of cardholder:
Cardholder’s signature:
Card issuer (please circle) Visa Amex MasterCard Delta Switch/Maestro
Card number
Valid from:
Expiry date:
Issue No (switch only):
Please enter the three/four digit CVV number:
Visa, MasterCard, and Maestro, the code is the last three-digit number located on the back of your card on or above your signature line. American Express, it is the four-digit number on the front.

We can only process applications where full payment has been made. This needs to be done by cheque, card or postal order. We cannot run Direct Debit payments for applications. If you are not eligible for membership you will receive a refund of the subscription fee but the application processing fees are nonrefundable.
Please note: The Society’s subscription year runs from January to December and future subscription payments are due in January regardless of when you first joined.
A full year’s subscription is always required upon application. If you join between:

Jan – June you will be charged the yearly rate which will all be allocated to this year’s subscription.

Jul – Sept you will be charged the yearly rate but half the payment will be carried forward reducing the amount due from you for the following year.

Oct – Dec your full payment will be allocated to the following year.
Membership will renew automatically at the end of each calendar year unless you notify the Society in writing (email accepted) that you wish to discontinue membership. Any balance arising from a change in subscription rates will be due on 1 January immediately following your admission.
Those applying to join the Society will need to pay £188 ( £128 annual subscription plus a one off £60 application processing fee).
There is a one off £40 application processing fee for Chartered Membership.
If you are applying to join a Division you will also need to enclose payment for that. The rates for each
Division are as follows:
Division Fee
Clinical Psychology
Counselling Psychology
Educational and Child Psychology
Scottish Educational Psychology
Forensic Psychology
Health Psychology
Neuropsychology
Occupational Psychology
Sport and Exercise Psychology
£16
£35
£30
£30
£15
£9
£15
£15
£15
£15 Academics, Researchers & Teachers in Psychology
If you have any queries regarding your application: e: applications@bps.org.uk t: +44(0)116 252 9911

(completed form should be enclosed with application)
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
Applicant: Mem No:
Referee: Mem No:
1. I have known the applicant for ……………… years and my relationship with the applicant is as a supervisor/work colleague/other (please give details).
.. .........................................................................................................................................
2. To the best of your knowledge is the information given on the application form correct?
 Yes  No If no, please give details (continue on a further sheet if necessary)
...........................................................................................................................................
...........................................................................................................................................
3. Given the criteria (below) and form , do you support the candidate’s application?
 Yes  No If no, please give details (continue on a further sheet if necessary)
...........................................................................................................................................
4. Please add additional comments regarding the applicant’s suitability (continue on a separate sheet if necessary)
...........................................................................................................................................
...........................................................................................................................................
Signed: Date:
Eligibility for Chartered membership
To be included on the list of Chartered members an applicant shall be a member of the Society and shall have established the Graduate Basis for Chartered Membership (GBC). It is acceptable for an applicant to apply simultaneously for Graduate membership, GBC and for Chartered membership.
Statute 5(2)(b) sets out the criteria for Chartered status. These require that, since the date of first becoming eligible for GBC an applicant:
“shall have successfully completed a period of study of, or practice in, psychology, or a combination of both, acceptable to the Board of Trustees, the relevant period being of three years’ duration if full-time or an equivalent period if part-time or such greater period as the Board of
Trustees may stipulate.”
Please note: Further information about each Division can be found on our website www.bps.org.uk/networks/divisions or call the Membership Team on +44(0)116 252 9911

(completed form should be enclosed with application form)


Applicant: Mem No:
Referee: Mem No:
1. I have known the applicant for ……………… years and my relationship with the applicant is as a supervisor/work colleague/other (please give details).
...........................................................................................................................................
2. To the best of your knowledge is the information given on the application form correct?
 Yes  No If no, please give details (continue on a further sheet if
necessary)
...........................................................................................................................................
...........................................................................................................................................
3. Given the criteria (below) and form, do you support the candidate’s application?
 Yes  No If no, please give details (continue on a further sheet if necessary)
...........................................................................................................................................
...........................................................................................................................................
4. Please add additional comments regarding the applicant’s suitability (continue on a separate sheet if necessary)
...........................................................................................................................................
...........................................................................................................................................
Signed: Date:
Eligibility for Chartered membership
To be included on the list of Chartered members an applicant shall be a Member of the Society and shall have established the Graduate Basis for Chartered Membership (GBC). It is acceptable for an applicant to apply simultaneously for Graduate membership, GBC and for Chartered membership.
Statute 5(2)(b) sets out the criteria for Chartered status. These require that, since the date of first becoming eligible for GBC an applicant:
“shall have successfully completed a period of study of, or practice in, psychology, or a combination of both, acceptable to the Board of Trustees, the relevant period being of three years’ duration if full-time or an equivalent period if part-time or such greater period as the Board of
Trustees may stipulate.”
Please note: Further information about each Division can be found on our website www.bps.org.uk/networks/divisions or call the Membership Team on +44(0)116 252 9911

As a professional body and as an employer, the British Psychological Society is committed to ensuring equal opportunities. For this reason we encourage all applicants to complete this equal opportunities form. Please note that it is not compulsory for you to provide this information.
You data is held securely and satisfies the confidentiality requirements of the Data Protection
Act. We will only ever provide aggregated data and will ensure that no individual can be identified by analyses.
Please  the box or write in your answers, as appropriate
Disability (tick as many boxes as appropriate)
Do you have a:
Learning impairment?
Mental impairment?
Physical impairment?
Sensory impairment?
Other impairment?
(please explain)
……………………………………………………………………………………………
Does your impairment mean that you have problems with your usual activities?
Do you often have to ask for changes to be made in order that you can take part in activities equally?
Please indicate the adaptations or personal assistance required to enable you to carry out your daily activities, e.g. provision of a note taker, support worker, etc.
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
Gender
Female
Male

Ethnic origin What is your ethnic group?
Choose one section from A to E then tick the appropriate box to indicate your cultural background
A White
British
English
Scottish
Welsh
Other, please state below:
……………………………………………………………………………………………
Irish
Any other white background, please state below:
……………………………………………………………………………………………
B Mixed
White and Black Caribbean
White and Black African
White and Asian
Any other mixed background, please state below:
……………………………………………………………………………………………
C Asian, Asian British, Asian English, Asian Scottish, Asian Welsh
Indian
Pakistani
Bangladeshi
Any other Asian background, please state below:
……………………………………………………………………………………………
D Black, Black British, Black English, Black Scottish, Black Welsh
Caribbean
African
Any other Black background, please state below:
……………………………………………………………………………………………
E Chinese, Chinese British, Chinese English, Chinese Scottish,
Chinese Welsh or other ethnic group
Chinese
Any other background, please state below
……………………………………………………………………………………………