Application form for CIEH Registration (EHRB registrants)

Use this form if you are EHRB Registered and wish to apply for CIEH Registration.

Personal and membership details

Title

First name *

Surname *

Membership number (registrants are required to be members of CIEH at the appropriate grade) *

Contact details

Work phone

Mobile phone

Email address *

EHRB Registration

My EHRB Registration number is *

CIEH Registration

I am applying for: *

Registered Environmental Health Practitioner status with CIEH

Registered Food Safety Practitioner status with CIEH

Continuing Professional Development

Choose one: *

I have uploaded the appropriate amount of CPD records, including evidence to MyCIEH

I will email the appropriate amount of CPD records, including evidence to CIEH by return when requested to do so

Payment

A fee is payable on application which covers Registration and your digital credential.

Once we receive your application form, one of our Contact Centre team will contact you to take payment which will need to be made via credit or debit card. If you wish to make payment via an alternative method, please call the Contact Centre on 020 7827 5800 to discuss options.

You will be issued with a receipt for your payment.

General Data Protection Regulations (GDPR declaration)

Evidence declaration

Declaration by applicant: I certify that the above information is correct. I acknowledge that ongoing CIEH Registration is conditional on maintaining my membership and CPD at the appropriate levels and complying with the requirements of the Code of Ethics and fitness to practise rules.

Name *

Date *

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