Membership Application Into The
Under
1999
PERSONAL
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Full
Name of Applicant
Date of
Application:|__|__|__|__|__|__|
M M
D D Y Y
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Home
& Mailing Address:
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Phone:
(Home) (Work)
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Fax:
E-mail:
Date of Birth:|__|__| |__|__|
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M M D
D Y
Y
Are you
a Canadian Citizen? Yes___ No___
POST-SECONDARY EDUCATION
University Training (Give names of Institutions and dates)
__________________________________________________________________________________________
Name
of
School
__________________________________________________________________________________________
Program
of Study
Start
Date:|__|__| |__|__| |__|__| Complete Date:|__|__|
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M
M D
D Y
Y M
M D
D Y Y
Degree Obtained:___________________________________________________________________________
Technical Training (Give names and dates)
___________________________________________________________________________________________
Name of School
___________________________________________________________________________________________
Program
of Study
Start
Date:|__|__| |__|__| |__|__| Complete Date:|__|__|
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M
M D
D Y
Y
M M D
D
Y Y
Title Obtained:______________________________________________________________________________
Please attach certified transcript from each institution.
EMPLOYMENT
State history of
forestry related employment in chronological order starting with your
present employment for the last 10 years. Give name of employer, address, supervisor,
location and position(s) held. Attach additional pages if
necessary.
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
State name and address of sponsoring Forester:_________________________________________________
_________________________________________________________________________________________
Name and address of two additional references:_________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
State any other training, experience or details that might influence your eligibility for Registration.
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
| Enclosed is a: Cheque ___ Money Order ___ | 1. Covering my application fee. ($25.00). 2. Applicable Membership Fee. (Make cheques payable to RPFANS) |
| I hereby apply for membership to the Registered Professional Foresters Association of Nova Scotia and the above is a statement of my personal & educational background, training and experience. | |
| _______________________________________________________________________Signature of applicant | |
RPFANS OFFICE
USE ONLY
Action Recommended
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$_____________________
M M
D D Y
Y
M M D
D Y Y
Amount received
Date application
received
Date fee
received
Recommendation to Examining Board:
_________________________________________________________________________________________
_________________________________________________________________________________________
Registrar, RPFANS________________________________________________________________________
EXECUTIVE ACTION
Date:____________________ Recommendations:___________________________________________
President, RPFANS _________________________________________________________________________
Secretary, RPFANS__________________________________________________________________________
Applicant notified:___________________________________________________________________________
Name entered in Register:____________________________________________________________________
Registration # entered in Registrar: ________________ Certificate forwarded:_________________________
SPONSORSHIP/REFERENCE FORM FOR MEMBERSHIP IN THE RPFANS
It is necessary that Sponsoring Forester be an R.P.F. and have intimate knowledge to the quality of the applicant's forestry work.
Applicant’s Forestry Work Experience:________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
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Character Reference:_______________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Recommendation:__________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Sponsor's/Reference Name:__________________________________________________________________
Title:_____________________________________________________________________________________
Address:__________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Date:_________________ Signature:__________________________________________________________