Forms

Forms

Membership application forms


Membership application form energy supply industry sector (subs from pay)   info

Membership application form Cymraeg/Welsh version   info

Membership application form   info

Membership application form (Isle of Man)   info

Direct debit mandate


Direct debit mandate form   info
If you don't already pay your Prospect subscriptions by direct debit, or if you need to change your existing direct debit mandate for any reason - for example if you move your bank account - use this PDF version of the mandate. If you currently pay by deduction from salary, the PDF includes an instruction to your employer to cease this.

Health and safety forms (some are for reps only)


Application form for funding for a training event   info
Application form for funding for a training event, updated December 2019

Application to fund a branch or regional training course   info
Please complete this if you are considering organising a branch/regional training course or event and are requesting funding.

Asbestos registration form   info
The asbestos register collects details of members’ workplace exposure to asbestos. The register provides evidence in support of a members’ claim on their own behalf, and to help pursue claims on behalf of colleagues or former colleague’s.

Benevolent fund application form   info
All current or retired members of Prospect and their dependants are eligible to apply for financial assistance from the Prospect Benevolent Fund. This is the application form.

Blank (PDF) safety rep inspection form from Brown Book   info
HSE-approved safety rep form for use when recording an inspection. Download for completion by hand. Go to Word version for electronic completion https://library.prospect.org.uk//download/2015/01693

Blank (PDF) safety representatives report form from Brown Book   info
HSE-approved safety rep form for use when notifying employer of a H&S concern. Download for hand written completion or use the following Word version for electronic completion https://library.prospect.org.uk//download/2015/01693

Complaints Form   info
This form should be completed when members wish to make a formal complaint.

Direct debit mandate form   info
If you don't already pay your Prospect subscriptions by direct debit, or if you need to change your existing direct debit mandate for any reason - for example if you move your bank account - use this PDF version of the mandate. If you currently pay by deduction from salary, the PDF includes an instruction to your employer to cease this.

GDPR photos and case studies permission form   info
GDPR consent form asking members for their permission to use their photographs or stories in Prospect publications and campaign materials, both in print and online. All members featured in any promotional materials or pictures must complete this form.

Members' expenses form to be paid by HQ   info
Expense form to be used by members from 28 November 2019, with a mileage rate of 33p per mile. Please complete if you are claiming expenses for attending centrally-funded meetings or branch expenses which are paid by HQ, ie NEC, NEC sub-committees, SESAC, RMG national and regional committees, Heritage Group, TUC, STUC, Blackworkers conference, BT committee, Scottish Power branch etc.

Membership application form   info
Prospect membership application form

Membership application form Cymraeg/Welsh version   info
Welsh language version of the direct debit membership application form, redesigned in 2017

Membership application form energy supply industry sector (subs from pay)   info
Use this form if you work in the energy supply sector and want your subscriptions to be taken directly from your pay.

Membership application form (Isle of Man)   info
PDF membership application form for use in the Isle of Man.

Personal case pro-forma   info
This four-page pro-forma is for reps to use when dealing with a personal case. It prompts you to ask all the relevant questions and record the answers when a member approaches you for help.

Political Fund opt out form   info
Form for members who wish to opt out of contributing to the Prospect political fund (except Northern Ireland)

Prospect's flexible working time account calculator   info
This excel spreadsheet, updated annually, allows members to record their daily hours of work. It supports the union's Work Time Your Time campaign by giving members a useful tool to track their hours while also reminding them of the need to take their hours (or TOIL) back.

Respirable Crystalline Silica (RCS) Registration form   info
registration form

Season Ticket Loan Form   info
Staff can use this form to apply for a Season Ticket loan

Staff expenses form December 2019   info
Generic form for staff expenses as at December 2019. (If you're a Prospect car user, you should have your own customised form - please don't use this one)

Expenses forms


Members' expenses form to be paid by HQ   info
Expense form to be used by members from 28 November 2019, with a mileage rate of 33p per mile. Please complete if you are claiming expenses for attending centrally-funded meetings or branch expenses which are paid by HQ, ie NEC, NEC sub-committees, SESAC, RMG national and regional committees, Heritage Group, TUC, STUC, Blackworkers conference, BT committee, Scottish Power branch etc.

Staff expenses form December 2019   info
Generic form for staff expenses as at December 2019. (If you're a Prospect car user, you should have your own customised form - please don't use this one)

Benevolent fund


Benevolent fund application form   info
All current or retired members of Prospect and their dependants are eligible to apply for financial assistance from the Prospect Benevolent Fund. This is the application form.

Personal case forms


Benevolent fund application form   info
All current or retired members of Prospect and their dependants are eligible to apply for financial assistance from the Prospect Benevolent Fund. This is the application form.
ID: 2009/00785

Asbestos registration form   info
The asbestos register collects details of members’ workplace exposure to asbestos. The register provides evidence in support of a members’ claim on their own behalf, and to help pursue claims on behalf of colleagues or former colleague’s.
ID: 2020/00131

Application to fund a branch or regional training course   info
Please complete this if you are considering organising a branch/regional training course or event and are requesting funding.
ID: 2020/00116

Staff expenses form December 2019   info
Generic form for staff expenses as at December 2019. (If you're a Prospect car user, you should have your own customised form - please don't use this one)
ID: 2019/01824

Members' expenses form to be paid by HQ   info
Expense form to be used by members from 28 November 2019, with a mileage rate of 33p per mile. Please complete if you are claiming expenses for attending centrally-funded meetings or branch expenses which are paid by HQ, ie NEC, NEC sub-committees, SESAC, RMG national and regional committees, Heritage Group, TUC, STUC, Blackworkers conference, BT committee, Scottish Power branch etc.
ID: 2012/00799

Season Ticket Loan Form   info
Staff can use this form to apply for a Season Ticket loan
ID: 2019/00312

Personal case pro-forma   info
This four-page pro-forma is for reps to use when dealing with a personal case. It prompts you to ask all the relevant questions and record the answers when a member approaches you for help.
ID: 2008/00478

Application form for funding for a training event   info
Application form for funding for a training event, updated December 2019
ID: 2018/02152

GDPR photos and case studies permission form   info
GDPR consent form asking members for their permission to use their photographs or stories in Prospect publications and campaign materials, both in print and online. All members featured in any promotional materials or pictures must complete this form.
ID: 2018/01891

Respirable Crystalline Silica (RCS) Registration form   info
registration form
ID: 2017/01515

Political Fund opt out form   info
Form for members who wish to opt out of contributing to the Prospect political fund (except Northern Ireland)
ID: 2013/00351

Membership application form energy supply industry sector (subs from pay)   info
Use this form if you work in the energy supply sector and want your subscriptions to be taken directly from your pay.
ID: 2016/02215

Complaints Form   info
This form should be completed when members wish to make a formal complaint.
ID: 2016/01044

Blank (PDF) safety rep inspection form from Brown Book   info
HSE-approved safety rep form for use when recording an inspection. Download for completion by hand. Go to Word version for electronic completion https://library.prospect.org.uk//download/2015/01693
ID: 2015/01694

Blank (PDF) safety representatives report form from Brown Book   info
HSE-approved safety rep form for use when notifying employer of a H&S concern. Download for hand written completion or use the following Word version for electronic completion https://library.prospect.org.uk//download/2015/01693
ID: 2015/01692

Membership application form Cymraeg/Welsh version   info
Welsh language version of the direct debit membership application form, redesigned in 2017
ID: 2015/00813

Membership application form   info
Prospect membership application form
ID: 2015/00812

Prospect's flexible working time account calculator   info
This excel spreadsheet, updated annually, allows members to record their daily hours of work. It supports the union's Work Time Your Time campaign by giving members a useful tool to track their hours while also reminding them of the need to take their hours (or TOIL) back.
ID: 2011/04158

Direct debit mandate form   info
If you don't already pay your Prospect subscriptions by direct debit, or if you need to change your existing direct debit mandate for any reason - for example if you move your bank account - use this PDF version of the mandate. If you currently pay by deduction from salary, the PDF includes an instruction to your employer to cease this.
ID: 2009/00784

Membership application form (Isle of Man)   info
PDF membership application form for use in the Isle of Man.
ID: 2008/00432