APPLICATION FORM TEMPORARY MEMBERSHIP

ONTARIO
PROFESSIONAL
FORESTERS
ASSOCIATION
APPLICATION FORM
TEMPORARY MEMBERSHIP
FOR OFFICE USE ONLY
APPROVED:____________
EFFECTIVE:___________
Please mail or fax completed application form to:
NON-RESIDENT MEMBER NO._______
Have you held an OPFA Temporary permit
or membership or permit previously?
Ontario Professional Foresters Association
5 Wesleyan Street, #201
Georgetown, ON L7G 2E2
L9S 1L5
 NO
YES (if so, date of last
occurrence________________
Phone: 905-877-3679 Fax: 905-877-6766
Email: [email protected] Website: www.opfa.ca
RENEWAL
Registered Professional Foresters (R.P.F.’s or ing.f), in good standing with the regulator of professional forestry in another
province may apply for a temporary membership in the O.P.F.A. in order to legally practice professional forestry. Such
membership is valid for a maximum of 3 months for the work and location (s) specified in the temporary membership and
may be held for a maximum of 3 periods in a year or 9 in 10 years. The Registration Committee approval is required by the
Act. It meets every 2 months. Meeting dates can be found on our website.
1.
MR.
 MRS.  MS.  MISS  DR. 
 FEMALE 
MALE
BIRTH DATE:_____________________
This above information is voluntary and for internal resources only of the OPFA.
The information will not be used or considered in connection with any decision regarding acceptance of the application
DATE OF APPLICATION: _________________________________
LAST NAME: ______________________________
GIVEN NAMES:___________________________
PREFERRED NAME:____________________________E-MAIL:
________________________________
RESIDENCE:_________________________________HOME NO.
(
)_________________________
CITY: ____________________________________ FAX NO.
(
)________________________
PROV: _________POSTAL CODE: ________________WORK NO. (
CELL NO. (
2.
3.
)_________________________
)_____________________________
I AM A MEMBER IN GOOD STANDING IN THESE PROFESSIONAL FORESTRY ASSOCIATIONS AND HAVE AUTHORIZED
THEM TO CONFIRM MY GOOD STANDING:
1.
__________________________________________________________ R.P.F. #_______________________
2.
__________________________________________________________ R.P.F. #_______________________
I HAVE NOT HELD A TEMPORARY O.P.F.A. CERTIFICATE MORE THAN TWICE WITHIN THE PREVIOUS YEAR ,
NOR MORE THAN 9 TIMES IN THE PREVIOUS 10 YEARS.
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4.
Description:
A) Please provide a description of the project and the professional work you will be performing:
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
B) Dates Temporary Membership required:
From:________________________
YYYY/MM/DD
To:__________________________
YYYY/MM/DD
C) Will you be working in Ontario or dealing with Ontario forests remotely, or both?
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
D)
Is any of the above information to be treated as commercially confidential ?: If so, specify:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
DECLARATION: A requirement for temporary membership in order to legally practice professional forestry relating to
Ontario’s crown land, private land or urban forests.
In lieu of writing the Ontario Forest Policy and Administration exam, a requirement, I declare that I have ensured that I
have sufficient knowledge of all relevant legislation, standards and guidelines required in order to competently perform the
work cited within all requirements.
Seal:
________________________________________
Signature
________________________________________
Date
You may submit this form electronically for consideration by the Registration Committee, but you should also mail a
signed sealed original which must be received before the certificate is issued.
5.
PAYMENT:
Temporary membership fees are $125.00 per term. Please include payment for each quarter for which membership is required .
$125.00 X _______(quarters-3 max) =
$_____________
Cheque

Visa/MC
#_______________________________________ Exp._______________
Name on card if different ___________________________________________
SIGNATURE OF APPLICANT:__________________________________
Note: Providing false information is considered professional misconduct.
DATE:____________________________
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