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Application Form for Licentiate Membership for those who have completed an accredited or recognised course

Applying for Licentiate Membership is quick and easy. Simply complete the form below, print and post it to us. You do not need to enclose any money. A request for membership subscription will be sent to you with your notification of election.

Please remember to enclose a copy of your degree and/or diploma certificate confirming that you have completed a recognised or accredited course with this form. For additional help and information, please refer to our guidance notes (PDF, 68 kb). If you have any questions please contact Jac Harris our Membership Executive on 020 7299 4504.

*Denotes mandatory field

Your details

Your title*

Your forename(s)*

Your surname*

Your date of birth (dd/mm/yyyy)*

Your home address*

Your home postcode*

Your contact telephone number*

Is this telephone number a home, work or mobile?*

Email address*

Membership division

Please state which division of the LI, Design, Management or Science, you are applying to join.*

Your qualifications

As part of the application, you will need to enclose a copy of your degree and/or diploma certificate, confirming that you have completed an accredited or recognised programme in full. If you are a graduate from an LI accredited programme in the UK, your name must appear on your schools final year pass list: this will be sent to the LI by your University/College.

Name of your university/college *

Full name of course *

Full name of the qualification you obtained (e.g. DipLA) *

Year you started the course (yyyy) *

Year you completed the course (yyyy) *

EU nationals

Are you an EU national from a country other than the UK? * yes no

Do you have a spouse who is an EU national? If you are not married click 'no' * yes no

Please select which of these applies to you and fill in neccessary details.

I hold a professional standing in an EU country

Country of qualification*

Name of regulatory body*

Address of regulatory body*

Website address of regulatory body

I practice the profession in another Member state which does not regulate the profession:

I have completed a relevant Higher Education course of at least three years duration, any necessary training preparing for the profession and practiced the profession for a minimum of two years *

Gift aid

You can now Gift Aid your subscription to the Landscape Institute. Under the scheme, every £10 we raise in subscription can be turned into £12.80 as long as payments are made through Gift Aid, at no cost to you. To qualify for Gift Aid what you pay in income tax or capital gains tax must at least equal the amount we will claim in the tax year.

I would like all donations I make in the future to be Gift Aid until I notify you otherwise.

If so, please confirm your eligibility:
I am a UK tax payer and pay an amount of income tax/capitals gains tax at least equal to the tax reclaimed on my donations
and
I do not claim tax relief on my subscriptions to the Institute against my earnings/profiles (see our Gift Aid Declaration Notes PDF, points 2 and 3)

Your declaration

I declare that the statements made by me on this application are a true account of education, training and experience. I agree to the automatic upgrading of my membership on the completion of the appropriate stages of qualification and undertake to pay the higher subscription charges involved (plus registration fee if applicable). I further declare that if elected I shall be bound by the Charter, By Laws and the Code of Professional Conduct of the Institute.

I agree

And finally...

Would you like to be kept up to date with the latest news and information from The Landscape Institute, including a free subscription to our email newsletter, Evista?

We take your privacy extremely seriously and promise not to share your details with anyone. No spam.

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