Membership application

Membership Fees
Number of employees Annual charge (excl VAT)
Less than 10 £125
Between 11 and 25 £250
Between 26 and 50 £500
Between 51 and 100 £750
Over 100 £1000
Self Employed/Independent* £5

Notes: All prices are exclusive of VAT at the governing rate
All fees exclude the cost of occupational health checks
* Charge per Independent Membership, these are only available for ‘Companies that have a number of employees who may need to work periodically on-site but is not their main job function’. This route does not give Company recognition of membership; refer to the CBH Contractor Guide for full membership benefits.

Complete the form below and we will contact you for payment details.

General information

Name of primary contact*

Job title*

Name of company applying for membership*

Main address*

Main telephone number*

Mobile telephone number

Email address*

Website address

Invoice address (if different to above)

Contact for invoices*

Telephone number

Email address

Number of staff employed*

Company registration No.*

VAT registration No.*

Do you currently have OH in place?*
YesNo

If yes to the above, who is your current OH provider?

Type of work undertaken*

Membership of trade association(s) – list those applicable

Name of client(s) & project(s) – list all relevant to application

How did you hear about us?*

If applying for independent memberships, how many are required?

Declarations

Please note: for independent memberships we will require the following information for each member, to complete the application process: Name/Address/Date of Birth/National Insurance Number/Job Role.

I accept and agree that CBH will forward my company details to their Accredited Providers if OH provision is not in place as stated on this application form.

I declare that to the best of my knowledge the information I have supplied in this application is fully up to date and accurate.

I accept that a failure to provide fully up to date and accurate information may invalidate my application or provide grounds for a withdrawal by CBH of the corporate rate.

I accept and agree to meet the terms and conditions of registration with CBH a copy of which is available on the CBH website and which I have read carefully.

I agree to pay corporate rate once an invoice is received from CBH.