Registration

Thank you for choosing to register as a sub-consultant with Betts Ecology. Please fill in the form below. All information will be treated in confidence and personal information will not be divulged to third parties outside Betts Ecology. Existing Betts Ecology sub-consultants should use this form to update their details.

You may also supply your current C.V. either by post to the Office Manager at the above address or by email to nature@bettsecology.com, but please fill in this form.

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BETTS ECOLOGY SUB-CONSULTANT REGISTRATION

GENERAL INFORMATION:

*Full Name:	*Title:
*Address line 1:	Address line 2:
*Town/City:	County:
*Postcode:	*Telephone (home):
Telephone (work):	Telephone (mobile):
*Email: (Please make sure you have entered your email address correctly!)
Fax:	Website:

ACADEMIC QUALIFICATIONS/PUBLICATIONS:

*Please list all first and higher degrees stating subject, grade obtained (including any distinction/honours), date awarded and the awarding university/institute for each:

Please list any relevant scientific papers or publications giving date, any co-authors, title and publisher. (If many, please supply separate list.)

PROFESSIONAL QUALIFICATIONS:

*Please list current membership of all professional institutes and other relevant learned bodies giving their name, your membership grade and the date you were elected:

SKILLS and PROFESSIONAL EXPERIENCE:

Please confirm in the list below all those subjects in which you have technical competence and experience. If you have any supporting certification (e.g. IdQ), please list these in the comment box at the end of the list.

Protected Species (general)	yes no
Mammals (general)	yes no
Badger	yes no
Bats	yes no
Dormouse	yes no
Otter	yes no
Water vole	yes no
Other mammals (please list):

Wild birds (general)	yes no
Kingfisher	yes no
Barn owl	yes no
Black redstart	yes no
Little ringed plover	yes no
Peregrine	yes no
Other birds (please list)

Herpetofauna (general)	yes no
Great crested newt	yes no
Common (viviparous) lizard	yes no
Slow-worm	yes no
Adder	yes no
Grass snake	yes no
Other herpetofauna (please list)

Freshwater fish (general)	yes no

Terrestrial macro-invertebrates (general)	yes no
Freshwater invertebrates (general)	yes no
Molluscs	yes no
Odonata	yes no
Orthoptera	yes no
Hemiptera	yes no
Lepidoptera	yes no
Diptera	yes no
Freshwater crayfish	yes no
Micro-fauna	yes no
Other terrestrial invertebrate groups (please list):

Other freshwater invertebrates (please list):

Other marine taxa (please give details):

Botany (general)	yes no
Vascular plants (general)	yes no
Bryophytes	yes no
Lichens	yes no
Fungi	yes no
Micro-flora	yes no
Woodland and scrub	yes no
Heathland / moor	yes no
Grassland	yes no
Marsh / swamp / bog / fen	yes no
Dunes, beaches	yes no
Cliffs, caves and rocky habitats	yes no
Disturbed and urban habitats (incl. gardens)	yes no
Arboriculture	yes no
Freshwater aquatic habitats	yes no
Coastal / marine aquatic habitats, including salt marsh and intertidal	yes no

Geology	yes no
Phase 1 survey	yes no
Phase 2 survey	yes no
River corridor survey	yes no
Woodland Grant Scheme	yes no
Environmental Impact Assessment	yes no
Nature Conservation Management Plans	yes no
Habitat creation	yes no
Habitat care and maintenance work (eg strimming, newt fencing)	yes no
Ecological engineering (reed beds, etc)	yes no
Biodiversity Action Plans	yes no
Planning Enquiries (expert witness)	yes no
Legal hearings (expert witness)	yes no
Training / lectures	yes no

*Please list all licences you hold for working with protected wildlife, giving date(s) and issuing authority:

If you have skills or experience relevant to work outside the UK, please give details (including any other languages besides English in which you are fluent):

Comments (Please give any additional supporting information, details of competency certificates, etc.):

*Are you competent with the major business software packages (Microsoft® Office, Adobe®, Corel®, etc)?	yes no
*Can you provide reports in Corel® WordPerfect® format?	yes no

RATES:

Hourly charge rate
Daily charge rate
Are you registered for Value Added Tax?	yes no

INSURANCE and HEALTH & SAFETY:

*Do you maintain public liability insurance cover?	yes no
If yes, what is limit per event?
*Do you maintain professional indemnity insurance cover?	yes no
If yes, what is limit per event?
*If you employ staff, do you maintain unlimited public liability insurance cover?	yes no
If no, please provide details:
*Do you have your own formal health and safety policy meeting current regulations?	yes no
If no, will you be willing in principle to work under the Betts Ecology health and safety policy?	yes no

REFERENCES (NEW REGISTRANTS ONLY):

*Please supply the names and contact details for three clients or employers for whom you have carried out work relevant to your skills and whom we may approach for a reference. (Please contact us if you have any difficulty fulfilling this requirement.)

We would also welcome a copy of a report as a recent sample of your work.

Reference 1

Reference 2

Reference 3

By ticking this box, I certify that my answers are true and complete to the best of my knowledge. I agree that the information given by me on this form may be held in files or electronic format by Christopher Betts Environmental Biology Ltd.

Betts Ecology
Bank House, Martley WR6 6PB
Tel: +44(0)1886 888445 Fax: +44(0)1886 888782 E-mail: nature@bettsecology.com
Website: www.bettsecology.com

Betts Ecology is a registered trading name of Christopher Betts Environmental Biology Ltd. Registered in England no: 4353460