TOHASA Membership Form

Email Address (*) NIDA number* Membership application*

Chartered Member (5+ Years of experience)

Graduate Member (2-3 years of experience)

Technical Member (less than 2 years of experience)

Student Member

Title*

Mrs

Ms

Mr

Dr

Prof

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First Name* Surname* Mobile* Gender*

Male

Female

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Address* Employment Status* Company (If applicable) Employment Position (If applicable)

* Indicates required question

Employment, Expertise & Experience (Max 150 words)* Education Level* Occupational Safety And Health Course*

NOSHC I

NOSHC II

NEBOSH IGC

NEBOSH Dip

IOSH

OTHER

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Expertise* Industries* Attach your CV* Attach Payment Receipt*

ACCOUNT NAME: TOHASA.
ACCOUNT NUMBER: 23310026789.
BANK NAME: NMB.

I agree to abide by TOHASA's terms and conditions

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Ensure all information is correct before submission.

INDIVIDUAL MEMBERSHIP REGISTRATION FORM