ACLS Membership Application

Do you hold a Canada Lands Surveyor (CLS) Commission?

YesNot yet - but I have applied for my CommissionNo

Please enter your CLS commission number:

If you don't have a Commission yet, please write "00000" in this box.

Please select which applied to you:

First time applicant - I have never held a membership with ACLSI have had a membership in the past but it has lapsedI currently hold a retired membership with ACLSI currently hold a student membership with ACLS

I am applying for:

Regular Membership: Must hold a Canada Lands Surveyor (CLS) Commission $420 (reduced by 50% after July 1st)Associate Membership: For persons who have an interest in the surveying profession but do not hold a CLS Commission $100.Student Membership

For Student (Candidate) membership, please apply at https://form.jotform.com/241974251914056

Name*

First NameLast Name

Personal Address*

Street Address

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

Do you hold a Provincial Commission*

YesNo

In which province do you hold a Commission?*

Members are required to respond to this questionnaire in accordance with the Canada Lands Surveyors Regulations (SOR/99-142), Section 2 and 3 (1). A CLS must annually complete the Declaration of Good Character, in order to renew their membership.

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

Do you have any current criminal charges against you in Canada or other jurisdictions?*

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.

FEES*

CLS Membership Fee (Before July 1st)

$420.00CAD

CLS Membership Fee (After July 1st)

$210.00CAD

Associate Membership (non CLS)

$100.00CAD

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

By pressing SUBMIT and paying the fee associated with ACLS membership, I declare that the above information contained in this application is true and correct to the best of my knowledge.

Membership Application

DECLARATION OF GOOD CHARACTER