PROPOSAL FOR ADMISSION OR TRANSFER OF GRADE OF MEMBERSHIP

Applicant Information
Name: / Date of Birth:
Postal Address: / City/Town:
Province/State: / Post Code: / Country:
Phone: / Mobile: / Fax:
Email address:
Declaration

I declare that I am desirous of becoming a (circle appropriate membership level)

Member / Associate / Technical Associate / Student / Member (work permit applicant)

of the Association of Surveyors of Papua New Guinea, and I hereby undertake upon election to agree to abide by the provisions of the constitution and By-laws of the said Association, and to pay all fees which under or by virtue of the said constitution and By-laws I shall be liable to pay. A statement of my professional experience, including dates of obtaining University Degrees, Certificate of Competency, or other professional qualifications, is included herewith.

Signature
of Applicant: / Date:
Employer, Supervisor and Professional Referee Contact Details
Name / Company/Organisation / Contact (phone/email)
Proposer Declaration (Not applicable for work permit applicants)

I, ______of ______a corporate member of the said Association, declare that the premises of this application are, to be the best in my belief, true; and I hereby nominate the above named ______whom I know personally, and believe to be a fit and proper person to become a ______member of the Association.

Signature
of Proposer: / Date:
Seconder Declaration (Not applicable for work permit applicants)

I, ______of ______a corporate member of the said Association, hereby second this nomination of the above named ______whom I know personally.

Signature
of Seconder: / Date:
Applicant qualifications and experience

The following documents are to be submitted with this application:

1.A current curriculum vitae describing in detail the following:

a. education (courses, diplomas, degrees),

b. examinations passed and qualifications obtained,

c. professional experience and practical training, and

d. present appointment and duties

2. Certified copies of diplomas, degrees, qualifications, certificates of competency and membership certificates of professional bodies

Payment of the following prescribed fees are to accompany this application:

Nomination Fee K125

(Not applicable for student membership or work permit applicants)

Work permit facilitation fee K800

(only for work permit applicants – includes nomination fee, current year membership and telephone interview fees)

Payment methods:

Cheque: Cheques to be made payable to The Association of Surveyors PNG

Direct Deposit:The Association of Surveyors of PNG, ANZ Waigani, BSB 018902 Account: 874150

Telegraphic Transfer:

Beneficiary: The Association of Surveyors PNG

Bank: Australia and New Zealand Banking Group PNG Ltd

Branch: Waigani, Papua New Guinea

Swift Code (BIC): ANZBPGPX

Account Number: 874150

If payment is made by Direct Deposit or Telegraphic Transfer, a copy of the deposit receipt or transmittal is required to be submitted with the application.

Recommendation
Date Received: / Proposal in Order:
Recommendation for Admission as:
Certificate Number: / Date of Issue of Certificate:
Signature
of Hon. Secretary / Date:

Send completedThe Association of Surveyors of PNGor send by email or fax

form and supportingPO Box 1392visit

documentation to:Boroko NCDfor the current email address or fax number

Papua New Guineaof the current Administration Officer