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Get MEMBERSHIP APPLICATION - Mari-Tech

Ess: Postal Code: Telephone: Date of Birth: E-Mail: Application for Election/Transfer to the Class of: Education (Please attach copies of relevant certificates): Certificate of Competency held: Certificate No: Present Position: Present Employer: Other Education or Experience (See Note 2 on reverse): Details Confirmed by Proposer: Date: Applicant Signature: Proposed By: Name (printed) Signature Roll No. Email Telephone Name (printed) Signature Roll No. Email Telephone Seconded.

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