APPLICATION FOR MEMBERSHIP

We __________________________________________________________________________________________________

(Full name of firm/company in block letters)

____________________________________________________________________________________________

hereby apply for membership of the Association of Consulting Town and Regional Planners.

The Partners/Directors/Members nominate:

______________________________________________________________________________________________________

(Full name and surname in block letters)

to act as authorized representative for the purposes of this application.

Partners/Directors/Members

Names Signatures

1. ……………………………………………………… ………………………………………………………

2. ……………………………………………………… ………………………………………………………

3. ……………………………………………………… ………………………………………………………

4. ……………………………………………………… ………………………………………………………

5. ……………………………………………………… ………………………………………………………

Dated this ……………………………… day of ………………………………………………. 2008.

______________________________________________________________________________________________________

1. This document together with Annexure A to be fully completed and returned to above address.

2. The contents of Annexure B to be read carefully before Annexure A is completed.

ANNEXURE A

APPLICATION FORM FOR MEMBERSHIP OF THE ACTRP

TO BE COMPLETED BY THE AUTHORIZED REPRESENTATIVE OF THE FIRM/COMPANY

DETAILS OF AUTHORIZED REPRESENTATIVE

(Hereinafter referred to as the applicant)

I, ……………………………………………………………………………………………………………………………………

(Full name and surname in block letters)

of …………………………………………………………………………………………………………………………………

(Full residential address where ordinarily resident)

being the authorized representative of the firm/company ……………………………………………….................

(Name of firm/company)

hereby apply for membership of the Association of Consulting Town and Regional Planners (ACTRP).

I declare that I practise as a Consulting Town and Regional Planner as defined in the Constitution of the ACTRP. I have read the requirements for membership and if my firm/company is accepted as a member, I, on behalf of my firm/company undertake to abide thereby. I am aware that the Committee may reject this application for membership.

I am not in partnership or association with any person or body whose conduct conflicts with the Rules of Conduct set out in the Constitution of the ACTRP.

Dated this …………………………. day of …………………………… 2008.

……………………………………..

APPLICANT'S SIGNATURE

POINTS WHICH THE APPLICANT MUST NOTE:

1. The application must be signed and fully completed.

2. The applicant must furnish two references herewith, both of whom must be registered Professional Planners and Corporate Members of the South African Planning Institute (SAPI).

NAMES OF REFERENCES IN BLOCK LETTERS

1. …………………………………………………………………………………………………………………………...

2. ……………………………………………………………………………………………………………………………

A. FURTHER DETAILS OF APPLICANT

The following particulars must be provided by the applicant.

All particulars to be typed or be in block letters.

1. GENERAL INFORMATION

(a) Full name:

…………………………………………………………………………………………………………………….........

(b) Postal Address:

…………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………….....

(d) Place of birth:

…………………………………………………………………………………………………………………………

(e)

Is the applicant a South African Citizen?

Yes

(f) Date on which the applicant was registered as a Professional Planner in terms of the Planning Professions Act, 2002 (Act 36 of 2002)

…………………………………………………………………………………………………………………………....

Registration number: ……………………………………………………………………………………................

N.B. A photocopy of the applicant's certificate of registration must be submitted with this application together with proof of membership of SAPI.

(g) The applicant must furnish details of his/her membership to other professional institutes or associations.

Institute/Association	Category of membership	Date Acquired

B. FURTHER DETAILS OF FIRM/COMPANY

1. Name of firm/company: ………………………………………………………………………….............................

Addresses of all offices and branch offices: (street and postal addresses, e-mail addresses, fax and telephone numbers).

…………………………………………………………………………………………………………………………..........

………………………………………………………………………………………………………………………………..

2. Please mark appropriate block to indicate type of practice:

	individual practice

	partnership

	close corporation

	incorporated company

	other form of practice (Please specify below)

__________________________________________________________________________

Partners/Director/or Members	Tertiary Qualifications	Professional Registration Number

Full names of all qualified town and regional planners in the employ of the firm/company (both registered and non-registered, excluding partners, directors or members listed above):

……………………………………………………………………………………………………………………………......

……………………………………………………………………………………………………………………………..….

3. Original date of establishment of the firm/company: …………………………………………………………….

4. Indicate whether the firm/company previously had another name and what the name was:

………………………………………………………………………………………………………………………………

5. An initial admission fee of R500-00 (once off payment) together with the annual membership fee of R610-00 per firm and 350-00 per qualified planner in the employ of your firm (directors/partners included), made payable to the Association of Consulting Town and Regional Planners (ACTRP), must accompany this application. The fee of R350-00 is not payable in respect of the authorized principal of the applicant i.e. the first qualified professional planner is not taken into account for this purpose. Where a firm or company has more than one branch office, an additional fee of only R450-00 is payable per branch office. For the purposes of calculating the annual membership fee, all qualified Planners in your employ, irrespective of experience, will be taken into account. Please use the table below to calculate your initial payment:

Admission fee:	R
· Head Office: 1 x R500 once off payment	500-00
· Annual fee: Head office: 1 x R610	610-00
· Annual fee: Branch offices: … x R450 (where applicable)
· Fees per planners employed (….. planners - 1) x R350
TOTAL

I hereby declare that the above information is true and correct.

Signed at ……………………………… on this …………………………. day of …………………………….. 2008.

………………………………………………

AUTHORIZED REPRESENTATIVE

ANNEXURE B

1. He/she must be in practice as a Consulting Professional Planner, either individually or as a partner of or as an employee in a firm offering Consulting Professional Planning services, and in all other respects comply with the definition of a Professional Planner.

2. He/she shall be registered as a Professional Planner in terms of the Act (Act 32 of 2002).

3. He/she shall be of such standing and experience that, in the opinion of the Committee, it makes him/her competent to practice as a Consulting Professional Planner.

4. He/she shall have conducted himself/herself in such a manner that his/her election to membership will not detract from the dignity or standing of the ACTRP.

5. He/she shall be a Corporate member of the South African Planning Institution (SAPI).

6. He/she will have had 5 years' post-graduate experience of a nature satisfactory to the Committee.