PSSA Application FormPSSA Application Form Company name*Person Making Application*Company Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*include dialling codeEmail* Website Turnovermost recent (annual)We hereby apply for the following membership(tick which is most appropriate from the list below):Member Type* Full Manufacturer InstallerA Manufacturer or both Manufacturer and Installer or test house of independently tested and rated high security perimeter protection products that can meet the full member membership criteria.An Installer must undertake installation works in respect of HVM and high security perimeter security products. These are specialist installation/project management companies that are not solely installers of their own brand product but are specialist perimeter security project management organisations.StandardsWhat standards are your products tested to? PAS68 IWA ASTMTestingWhich test houses are your products tested in?Business Type Manufacturer/supplier Manufacturer/supplier and installer (Own products) General Installer/Contractor/Project Management organisation Product testing organisation Other (please state below)Business Type OtherApplication Reason*We hereby apply for membership of the PSSA and our organisation is best described as follows:We have read and understand the criteria for our member application of the PSSA and in support of our application will provide:(please email documents to admin@pssasecurity.org)Application Details Proof of Trading for at least 3 years Copy of ISO9001 accreditation A copy of our current health and safety policy plus evidence that we either have our own employed health and safety manager or that we have an externally retained advisor Copy of Environmental policy Evidence of Credit risk ratingCompanies who have applied under the category of General Installer/Contractor/Project Management organisation should also provide the following:(please email documents to admin@pssasecurity.org)Application Details 2 Proof of being on the formal relevant approved supplier list of at least 2 separate government departments or utility companies or Major Contractors with PLC status. This can be approval directly by the organisations themselves or via Achilles or Building Confidence or Constructionline certification Evidence of a Health & Safety accreditation to any scheme included in the current list of SSIP approved schemes (Safety Schemes in Procurement), for example, CHAS.We agree to accept the terms and conditions of the Memorandum and Articles of Association of PSSA together with its Byelaws (available on request) and undertake to pay such annual subscription as shall from time to time be fixed by the Association in General Meeting.We agree to abide by the membership criteria applicable and understand that a minimum of 6 months notice in writing is required to be given by us in the event that we choose to terminate our membership. Membership fees at normal rate will be charged for the notice period. In writing shall include in electronic form such as email or fax provided that there is either electronic proof of delivery or an actual acknowledgement of delivery.We understand that our application is subject to approval by the Management Council of the PSSA.We agree to pay the appropriate annual subscription as set by the Association.We agree that once this form is returned to the PSSA office an invoice will be sent.Signature*Print Name*Date MM slash DD slash YYYY reCAPTCHA
