Chartered Institute of Logistics and Transport   Institut agréé de la logistique et des transports
North America Amérique du Nord
275 Slater Street, Suite 900, Ottawa, Ontario, Canada K1P 5H9
        Phone (613) 688-1438     Fax: (613) 688-0966    Info@citna.com     www.citna.com

Please fill and send this Form  to the CILTNA at the above address accompanied by a Curriculum Vitae including education, employment history and $75  Certification dues.

RECOMMENDATION FOR ELECTION

    Surname   ............................................................  Forename   ....................................................

    Title   .......................................................................................    Please state if retired   

    Present Position   .............................................................................................................................

    Company Name   .............................................................................................................................

    Address   ...........................................................................................................................................

    City   .......................  Province/State  ......................   Country  ..................  Postal Code  ................

    Telephone  ............................ Fax   ................................  E.mail   ....................................

    Current or Past Membership Grade  ................. Date  ................ Membership Number  ................

Recommendation by Corporate Members:  I have read the particulars on this application and from personal knowledge recommend the candidate to the Council as a proper person in every respect for election to Membership in The Chartered Institute of Transport.  The signatories are requested to initial any details of which they have personal knowledge. Applications require 3 signatures (of equal or higher level) prior to submission. Signatories must be in good standing.

Sponsor   ...................................................................................................   Appointment Held  .................

Signature   .................................................................................................   Membership Grade .................

WE, THE UNDERSIGNED CONCUR IN THE FOREGOING RECOMMENDATION:

Sponsor   ....................................................................................................   Appointment Held  .................

Signature   ..................................................................................................   Membership Grade  ...............

Sponsor   .....................................................................................................   Appointment Held  ................

Signature   ...................................................................................................   Membership Grade  ..............

I certify that the statements in this form are correct and promise that in the event of my election I will be governed by the code of Professional Conduct,  Charter By-laws of the Institute and will promote the objectives of the Institute as far as shall be in my power and attend its meetings as often as I conveniently can. Should I at any time desire to withdraw from the Institute,  I will, in accordance with the By-laws, after payment of all subscriptions or other sums due from me including the subscription for the current year, send my resignation in writing to the office and return therewith any certificate held by me.
 

Signature of Candidate ................................................................... Date   ..................................