Membership form

About you

Title

Name

Date of birth (DD/MM/YYYY)

Spouse/Partner: Name

Address line 1

Address line 2

Town

County

Postcode

Home telephone number

Mobile telephone number

How would you like us to contact you?

Email
Home telephone
Mobile telephone
No reply

Further information

National Insurance number (this is required so that Kier HR can re-instate it for the benefit of Kier Rewards)

Are you retired?

Yes
No

What was/is your occupation after leaving Kier?

While employed with the Group, which was the last Kier company you worked for?

Years employed by Kier

Do you have an enquiry or suggestion in addition to your membership application?

Privacy

I acknowledge the terms of your Kier Fellowship privacy notice