CHECKLIST FOR RETIRED or CANCELLATION OF MEMBERSHIP and/or CANCELLATION OF LICENSE TO PRACTICE

CHECKLIST FOR RETIRED or CANCELLATION OF MEMBERSHIP and/or CANCELLATION OF LICENSE TO PRACTICE

Name

First NameLast Name

Primary Email

example@example.com

Alternate Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Select that which applies

I would like to cancel my license and maintain a regular membership with ACLSI would like to cancel my license and move to a retired membership with ACLSI would like to cancel my license and membership completelyI would like to cancel my membership (I currently do not have a license)

If you plan to obtain a license to practice again at a later date please note the process below. Application and other fees may apply.

1. Do I have unfinished project(s) on Canada Lands or private lands in the territories?

YesNo

(the word “unfinished” means projects were there is a need for more tasks to be performed by CLS to satisfy a client requirements such as for example a project where monuments have been placed but no plan was drafted or field notes recorded.)

If yes, have you made arrangements for the project(s) to be taken over by another licensed CLS?

YesNo

If yes, what is the name & email of the CLS?

Note: If in a project, you placed survey monuments in the field but no plan was recorded in the CLSR, the Association strongly recommends that you record field notes so that other surveyors may refer to these in the future.

2. Do you have survey document(s) that are destined to be recorded but are held up for reasons such as waiting for approval(s) or signature(s) for example?

YesNo

If yes, have you made arrangements for the project(s) to be taken over by another licensed CLS?

YesNo

If yes, what is the name & email of the CLS?

3. If you did not practice as a federal or provincial public servant, did you make arrangements to protect yourself and your close ones financially by securing past action professional liability insurance?

YesNo

4. Please provide the location of where your survey files will be stored:

Note: If you have questions or concerns about the above mentioned items, please contact the Association of Canada Lands Surveyors Registrar for assistance at registrar@acls-aatc.ca

I acknowledge that: (a) I have read the ACLS General By-laws and understood the benefits, obligations and restrictions of membership as a Retired Member; and will keep up-to-date on amendments to the by- laws; and (b) in the event that I wish to begin to engage in the practice of land surveying on Canada Lands and private lands in the territories again, that I will inform the ACLS immediately, and will apply membership as a Regular Member, and a licence in accordance with the Canada Lands Surveyors Act and regulations.

Signature