Membership Reference Form
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9MEMBERSHIP REFERENCE FORM
Note to the Applicant: Please print neatly or type the name and address of the Referee whom you have
asked to complete this form, along with the date that you are sending it to the Referee and your name as
given on your application form. The Referee’s name and address must also be given in Section 6 of your
application form. Please include a copy of the Work Experience Record along with this form.
Note to the Referee: All statements will be maintained in a confidential manner.
Referee’s Name:
Date:
Address:
Applicant's
Name:
Application No: __________________________
(from front of application)
ASSOCIATION OF PROFESSIONAL GEOSCIENTISTS OF ONTARIO
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Parent category: Letters