APPLICATION FORM TO BECOME A CANDIDATE FOR A CANADA LANDS SURVEYOR COMMISSION

APPLICATION FORM TO BECOME A CANDIDATE FOR A CLS COMMISSION
Name*

First NameLast Name
Personal Address*

Street Address

Street Address Line 2

CityProvince

Postal code
Personal Phone Number*
Company or Employer
Office Address

Street Address

Street Address Line 2

CityProvince

Postal code
Office Phone Number
Email*
example@example.com
Please add a government issued proof of identification

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Do you hold a Provincial Commission*

YesNo
In which province do you hold a Commission?*
Date your Commission was issued*

MonthDayYear
Date
Certificate of Conduct from Provincial Association

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CBEPS Certificate of Completion number
Certificate of Completion Date

MonthDayYear
Date
Please upload a copy of your Certificate of Completion

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Once you submit this form, you will be redirected to the payment portal. Forms submitted without a completed payment will not be processed and will be discarded.

The candidate registration fee of $175.00 will be refunded to you if you are not accepted as a candidate.
DECLARATION OF GOOD CHARACTER

Members are required to respond to this questionnaire in accordance with the Canada Lands Surveyors Regulations (SOR/99-142), Section 2 and 3 (1).

CLS applicants, accepted as candidates, are also required to complete the Good Character Questionnaire. Further, a CLS must annually complete the Declaration of Good Character, in order to renew their membership.
Good Character Questionnaire
Do you have any current criminal charges against you in Canada or other jurisdictions?*

YesNo
Have you ever pleaded guilty or been convicted of a criminal offence in Canada or other jurisdictions where a pardon has not been granted?*

YesNo
Have there been any other situations in which your good character has been called into question?*

YesNo
Have you ever been suspended, required to withdraw, expelled or penalized for misconduct from an academic institution?*

YesNo
Do you have any outstanding complaints, complaint investigations, or disciplinary proceedings with a professional regulatory organization or agency?*

YesNo
Have you ever been found guilty of unprofessional conduct or unskilled practice by a professional regulatory organization or agency resulting in loss of practice?*

YesNo
If you have answered “yes” to any of the above questions, page please provide a brief description below and any factual information regarding the complaint, professional misconduct, criminal charge, conviction and/or criminal offence. Please also describe all of your rehabilitation or self-improvement activities. You may be contacted directly, should additional information be required by the Registrar.
I declare that the above information is true and correct to the best of my knowledge.*

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Candidate Registration Fee
$175.00CAD

Total

$0.00CAD
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APPLICATION FORM TO BECOME A CANDIDATE FOR A CLS COMMISSION

Good Character Questionnaire