Affiliate Membership - CIPD

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Section 3 – 2011 Membership QuestionnaireWe’re keen to ensure you’re kept up to date with all member benefits available to you.We ask all our members to complete a membership questionnaire as this informationhelps us to support you.The information you provide will assist CIPD and its subsidiaries in developing anddelivering relevant products and services to you which will help to meet your personaland professional development needs.Please help us to keep you informed and updated by ensuring all your contact detailsare correct – let us know straight away if your details change.For office use onlyMembership no. .....................................................................................................Name ......................................................................................................................Email communicationHomeBusiness4 Membership of other organisationsPlease indicate you or your organisation’s membership of other professional bodies1 Chartered Management Institute2 Institute of Occupational Safety and Health3 Institute of Directors4 The British Psychological Society5 CBI6 Law Society/Scottish Law Society7 The Work Foundation8 ITOL9 Institute of IT Training10 Institute of Leadership and Management11 Other (please specify)....................................................................................................................................5 Membership subscription reimbursementIs your membership subscription reimbursed by your employer?PM DailyLocal branch1 Yes 2 No 3 I am self-employed and my business pays1 Your main interestsPlease indicate your main areas of interest (tick all that apply)1 Change management2 Coaching/mentoring3 Corporate social responsibility/sustainability4 Diversity and equal opportunities5 Employee branding6 Employee communications7 Employee engagement8 Employee relations/trade unions9 Employee well-being10 Employment law11 Health and safety12 HR metrics13 HR policy development14 HR systems and technology15 International HR16 International reward/expatriate management17 Leadership and management development18 Leading and managing the HR function19 Learning and development strategy20 Occupational psychology21 Organisation design22 Organisation development23 Pensions24 Performance management25 Programme management26 Public policy issues27 Recruitment and selection28 Reward management29 Shared services (including HR outsourcing)30 Talent management31 Technology based training including e-learning32 Training delivery33 Training design34 Workforce planning35 Other (please specify)...................................................................................................................................2 Are you operating in a specialist role?1 Yes 2 NoIf yes, what is your area of specialism? (choose one number from the list above)33 Current education levelPlease indicate the current level you have reached in academic education0 No formal qualifications1 Secondary education2 National certificate/diploma/Level 2 NVQ/SVQ3 Higher national diploma/Level 3 NVQ/SVQ4 Level 4–5 NVQ/SVQ5 Degree6 Postgraduate qualification7 Master’s degree8 Doctorate9 MBA6 Employment statusPlease indicate your current employment status (tick all that apply)1 Full-time2 Part-time3 Job share4 Temporary/fixed term/interim5 Self-employed6 Retired from full-time employment7 Not in paid employment8 Full-time student7 Job levelPlease indicate which of the following most closely describes your role1 Director: Top executive with overall responsibility for own function withboard membership or equivalent, including MD, CEO, Chairman and DG.2 Senior executive/group role: Top executive with overall responsibility butwithout board membership or equivalent.3 Manager: Individual with responsibility for an activity within the overallfunction – may be a senior HR specialist or in a broader HR role. Makes asignificant contribution to policy formulation.4 Senior officer: Individual in senior position with strong professional role –may have supervisory responsibilities for departmental work and/or managea small team.5 Officer: An experienced officer with first level of professional responsibilitybut with more than two years’ experience as an officer.6 Administrator/Assistant: A less experienced officer with under two years’experience in function.7a In-house consultant/Adviser: Individual working within an organisationon a programme/project, possibly cross-functionally.7b Independent consultant: Individual providing consultancy services toorganisations on a freelance/contractual basis.8 Lecturer8 Industry sectorA Agriculture, forestry and fishingB Mining and extractionC ManufacturingD Electricity, gas and water supplyE ConstructionF Retail and wholesaleG Hotels and restaurantsH Transport, storage and communicationI Finance, insurance and real estateJ Professional/consultancy servicesK IT industryL Public administration and defencea) Public administration – central governmentb) Public administration – local government, including schools and fire servicesc) Navyd) Armye) Air Forcef) PoliceM Education – further and higherN Health and social careO Voluntary and not-for-profit (Third sectors)P Other private sector servicesQ Media9 Size of organisationApproximate total number of people employed by your organisation in your country.1 1 – 9 6 1,000 – 4,9992 10 – 49 7 5,000 – 9,9993 50 – 99 8 10,000 – 19,9994 100 – 499 9 Over 20,0005 500 – 999Continued overleaf ...
Section 3 (continued)10 Size of departmentNo. of people within the HR/training department(s) at your site.1 1–2 5 20–492 3–5 6 50–993 6–9 7 100–4994 10–19 8 500+11 Key responsibilitiesPlease indicate your main areas of responsibility (please tick one)A HRB Learning and developmentC HR and learning and developmentD Another HR specialismE Another function (eg finance)F Industry supplier12 Geographic responsibilitiesWithin which geographic area(s) are you responsible for/have influence over HRmanagement and/or development activities?1 UK and Ireland2 Europe (excl. Central and Eastern Europe)3 Central and Eastern Europe4 Middle East5 Africa6 Americas7 Asia/Pacific8 South Asia13 Areas of purchasing responsibilityPlease indicate if you have influence in purchasing the following products/services1 In-house training/development programmes2 Courses (open)/conferences3 Training DVDs/packages4 Development of HR capability5 Books/magazines6 HR consultancy services7 Online HR/employment law information services8 Recruitment advertising9 HR software systems10 Qualification-based programmes for HR/L&D employees14 Experience levelHow many years experience do you have in HR/learning, training and development?1 (1–3 years)2 (4–9 years)3 (10–19 years)4 (20+ years)How many years people management experience do you have?1 (1–3 years)2 (4–9 years)3 (10–19 years)4 (20+ years)15 Employment classificationPlease indicate your organisation’s employment classification1 Public sector2 Voluntary and not-for-profit (Third sector)3 Private sector – manufacturing4 Private sector – services16 Salary levelPlease indicate your annual salary (including bonuses)1 Up to £14,9992 £15,000 – £19,9993 £20,000 – £29,9994 £30,000 – £44,9995 £45,000 – £69,9996 £70,000 – £99,9997 £100,000 – £129,9998 £130,000 – £149,9999 Over £150,000쀀Sensitive personal data (optional)We appreciate your co-operation in completing these questions, as they will help usto monitor our progress in developing a diverse membership and deliver services thatare fair to all our members.1 Nationality.................................................................................................................................2 Description of ethnic origin1 White1a British1b Irish1c Any other white background (please specify).................................................................................................................................2 Mixed2a White and black Caribbean2b White and Asian2c White and black African2d Any other mixed background (please specify).................................................................................................................................3 Asian or Asian British3a Indian3b Bangladeshi3c Pakistani3d Any other Asian background (please specify).................................................................................................................................4 Black or black British4a Caribbean4b African4c Any other black background (please specify).................................................................................................................................5 Chinese or other ethnic group5a Chinese5b Any other (please specify).................................................................................................................................3 Physical status1 Do you regard yourself as having a disability?Yes No2 Do you have access needs?Yes No3 If yes to 1 or 2, please describe what these are:.................................................................................................................................For your security and peace of mind, we will not supply yourdetails to any organisations for marketing purposes. By submitting yourmembership questionnaire you agree that CIPD and its subsidiaries may use yourdetails as explained in this questionnaire. Your participation helps us to betterunderstand the profession, please complete this questionnaire even if you do notwant to hear about our latest products and services. Please refer to our privacypolicy (cipd.co.uk/absite/privacy or call +44 (0)20 8612 6208) for more details,including to let us know if for any reason you would not like to receive marketingcommunications from us.June 2011
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Affiliate Membership - CIPD

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