Please Complete the Below Application

The below application is required to be considered for IACSP membership

Standard Membership Dues

Membership dues are $50 per year, with a one-time application fee of $20 during your initial signup.

Dues are billed annually from your initial sign-up date and are payable either by credit card, PayPal, or check.

Membership Application

Please complete the following form. You will receive another email advising when your membership is complete and will then be asked to proceed to payment to access members only content.

Personal Information
Preferred Mailing Address
Name*
First Last
Company Address
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Work Phone*
Work Email*
Director's Name*
First Last
Director's Email*
Director's Phone*
Fax
Home Address
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Fax
Email*
Taxpayer Identification Number (W9 Form)
- Yes, please send a completed W9 form to my preferred mailing address
- Yes, please send a completed W9 form to the address below
Name
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employment Information
Current Employer*

Current company or employer
Date Employed*
MM slash DD slash YYYY
Current Job Title*
Current Department*
Current Responsibilities*
Description of Surveillance Duties and Responsibilities
Employment History
10-year history is required, starting with most recent.

Company	Job Title	Start Date	End Date	Actions

There are no Employment Records.

Statement and Signature
Are You a U.S. Citizen?*
Convicted of a Felony?*
Have you ever been convicted of a felony?
Security Clearance Revoked?*
Have you ever had any type of security clearance suspended, denied, or revoked?
Explanation
Provide an explanation to any "yes" response above
Confirm Membership Application*
- I do hereby apply for membership in the International Association of Certified Surveillance Professionals
Confirm Truth of Information*
- I certify that all information herein is true and complete to the best of my knowledge and belief. I authorize verification of this information, and release all concerned from any liability in connection therewith. I hereby apply for membership in the International Association of Certified Surveillance Professionals and have read and understand the qualifications of membership, processing fees, and dues payment requirements. I agree to abide by the Associations Bylaws, to adhere to its Code of Ethics, and to promote its objectives. Providing false or misleading information in the application form or failure to adhere to IACSP Bylaws and Code of Ethics shall be grounds for denial of membership or expulsion from the Association whenever discovered.
Signature*
First Last
Date*
MM slash DD slash YYYY

Save and Continue Later

Processing Notice

Please allow 30 days for complete processing upon receipt of your application and payment. Membership is individual and is not transferable form one person to another. Dues and processing fees are non-refundable.

Please Complete the Below Application

Standard Membership Dues

Membership Application

Personal Information

Company Address

Home Address

Taxpayer Identification Number (W9 Form)

Employment Information

Employment History

Statement and Signature

Processing Notice

Certification