Application for Associate Membership

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Apply for Associate Member

First Name*

Middle Name

Last Name*

Title*

Date of Birth*

/ /

Gender

We recognise that gender identity can be expressed in different ways. Please select the option that best describes you.

Telephone*

Email Address*

Secondary Email Address

LinkedIn Profile

Personal Address

Personal Address Line 1*

Personal Address Line 2

Personal Address Line 3

Personal Town*

Personal County / State

Personal Postcode / ZIP

Personal Country*

Business Address

Business Address Line 1

Business Address Line 2

Business Address Line 3

Business Town

Business County / State

Business Postcode / ZIP

Business Country

Select Address

Correspondence Address

Invoicing Address

About You

Job Title

Education Level*

Education Level (if Other)

Education Provider

Education Provider (if Other)

Qualification Award Title

Graduation Date

Either the date of graduation, or, the anticipated future date of graduation

/ /

Start of program

Date of University Course Start

/ /

Digital Newsletters

Would you like to receive any of the following members' only, digital newsletters?

Show on Member Directory

When ticked, you agree to your Name, Subscription Level and Engineering Council level, being publicly listed on the RINA Member Directory.

Mentor / Mentee

I would like to be a mentor

I would like to be assigned a mentor

Confirm*

I confirm the information entered is correct and I will update this information if it changes within a reasonable amount of time.

*Indicates a field you must enter.

Kindly note - Your application / upgrade fee is non - refundable. However, if your initial application is unsuccessful, you will receive feedback and the opportunity to resubmit without charge.