diff --git a/templates/fragments/applications/member_perms_form_fields.html b/templates/fragments/applications/member_perms_form_fields.html
new file mode 100644
index 00000000..a22d72ba
--- /dev/null
+++ b/templates/fragments/applications/member_perms_form_fields.html
@@ -0,0 +1,51 @@
+{% from "components/checkbox_input.html" import CheckboxInput %}
+
+{% macro MemberPermsFields(app_perms_form, env_roles_form, new=False, member_role_id=None) %}
+
+
{{ "portfolios.applications.members.form.project_perms" | translate }}
+
+ {% if new %}
+ {% set team_mgmt = app_perms_form.perms_team_mgmt.name %}
+ {% set env_mgmt = app_perms_form.perms_env_mgmt.name %}
+ {% set del_env = app_perms_form.perms_del_env.name %}
+ {% else %}
+ {% set team_mgmt = "perms_team_mgmt-{}".format(member_role_id) %}
+ {% set env_mgmt = "perms_env_mgmt-{}".format(member_role_id) %}
+ {% set del_env = "perms_del_env-{}".format(member_role_id) %}
+ {% endif %}
+
+ {{ CheckboxInput(app_perms_form.perms_team_mgmt, classes="input__inline-fields", key=team_mgmt, id=team_mgmt) }}
+ {{ CheckboxInput(app_perms_form.perms_env_mgmt, classes="input__inline-fields", key=env_mgmt, id=env_mgmt) }}
+ {{ CheckboxInput(app_perms_form.perms_del_env, classes="input__inline-fields", key=del_env, id=del_env) }}
+
+
+
{{ "portfolios.applications.members.form.env_access" | translate }}
+
+ {% for environment_data in env_roles_form %}
+
+
+
+ {{ environment_data.environment_id() }}
+
+ {% endfor %}
+
+
+{% endmacro %}
diff --git a/templates/fragments/applications/new_member_modal_content.html b/templates/fragments/applications/new_member_modal_content.html
index 7851e22f..b1fb3b80 100644
--- a/templates/fragments/applications/new_member_modal_content.html
+++ b/templates/fragments/applications/new_member_modal_content.html
@@ -2,6 +2,7 @@
{% from "components/text_input.html" import TextInput %}
{% from "components/checkbox_input.html" import CheckboxInput %}
{% from "components/phone_input.html" import PhoneInput %}
+{% from "fragments/applications/member_perms_form_fields.html" import MemberPermsFields %}
{% macro MemberFormTemplate(title, next_button, previous=True) %}