Summary
IIRSM and Avetta are delighted to be working together on this exciting new initiative to help encourage safety professionals from across the Middle East to become part of the global risk community. Successful applicants will receive Avetta-sponsored membership of IIRSM, providing them with access to a unique community, expertise and knowledge to help them thrive.

Application form
We’d appreciate if you’d please complete all sections of this form. Sections marked with * are required fields. Forms received with incomplete sections may not be processed.

All information provided in this form will be treated in confidence. Please be aware that we will make necessary validations which may include, for example, checking your professional membership or training records, making enquiries to the organizations named in this form, and checking your employment status.

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* 1. Personal Details

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* 2. Home Country

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* 3. Email Address

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* 4. Sex

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* 5. Applicant’s date of birth

Date

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* 6. Applicant's occupation

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* 7. Membership of any professional bodies
(Please list body and grade of membership)

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* 8. Your most recent role title

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* 9. Your most recent employer’s name and address

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* 10. Employment dates
(for your most recent employment)

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* 11. Summary of your duties in this role
(Maximum 250- 300 words)

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* 12. If not in work, date you became unemployed in this role

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* 13. Reason(s) for unemployment

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* 14. Country of residence

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* 15. How can the Salama Bursary help you?

Please be specific in why you should be chosen for The Salama Bursary. Include why you’re committed to risk and safety management and how IIRSM membership will support your professional development

(Maximum 250-300 words)

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* 16. Do you give permission for your name to be used in promotional material and on social media if you are selected for the bursary?

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* 17. If you are happy to be tagged in LinkedIn posts, please leave your LinkedIn profile below.

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* 18. In submitting this application, I consent to the Avetta and IIRSM carrying out any necessary checks to verify the information provided in this form.

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* 19. Signature of Applicant

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* 20. Date

Date

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* 21. Please upload your up-to-date Curriculum Vitae

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