Membership Application

IF YOU ARE APPLYING AS A NEW MEMBER, PLEASE COMPLETE SECTION 1, SECTION 2, SECTION 3 & SECTION 4.

IF YOU ARE RENEWING YOUR MEMBERSHIP PLEASE COMPLETE ONLY SECTION 1.

 

SECTION 1: CONTACT INFORMATION

Please supply the following information for our membership database.

*

Name:

*

Job Title:

*

Employer:

*

Address:

*

Phone Number:

Fax Number:

*

Email:

*

Membership Type:

Full ($50) Associate ($40) Student ($10) Corporate ($100)

 

 

SECTION 2: EDUCATIONAL INFORMATION

Applicants are required to submit documentation as proof of education to the AAPT Membership Chair (contact information is provided at the bottom of this application).  A professional resume may be submitted in lieu of Section 2 and Section 3.

FOR STUDENTS:  If you are applying for a student membership, your current instructor is required to send a letter to the AAPT Membership Chair confirming that you currently are a student (contact information is at the bottom of this application).

Please provide your information most relevant to this application for membership starting with the most recent.

School or Institution:

Start Date:

End Date:

Academic Qualifications (level achieved):


School or Institution:

Start Date:

End Date:

Academic Qualifications (level achieved):


School or Institution:

Start Date:

End Date:

Academic Qualifications (level achieved):

 
 

SECTION 3: EMPLOYMENT EXPERIENCE


Please provide your information most relevant to this application for membership starting with the most recent.

Employer:

Address:

Position or Title:

Start Date:

End Date:


Employer:

Address:

Position or Title:

Start Date:

End Date:


Employer:

Address:

Position or Title:

Start Date:

End Date:

 


SECTION 4: REFERENCES


Please provide the name and addresses of two (2) people who are in a position to verify your experience.

Name:

Employer:

Position or Title:

Phone:


Name:

Employer:

Position or Title:

Phone:

 


Following the submission of your membership application, the AAPT Executive will review your application and inform you as to whether or not you have been approved.  Should your application be approved, we will provide you with instructions on submitting payment for membership dues.

We accept the following forms of payment: cash, cheque, money order, e-transfer.

Should you have any questions, please contact:

Tracy Robinson, AAPT Membership Chair
membership@aapt.ca
 
Please click the submit button below to complete your application.