APRIL 2015
Enclosed is your ‘Transfer Application for Registration’ for Registered Onsite Wastewater
Practitioner.
At the time you submit your Application, you must also order your personal stamp. This seal
or stamp remains the property of ASTTBC and must be returned promptly at the request of the
Registrar of ASTTBC. We will hold your Application for Stamp on file until Application for
Registration is reviewed. If registration is approved we will have your personal stamp
produced and mailed directly to you.
A non-refundable Application fee and your stamp fee must accompany this application.
Please make your cheque or money order payable to ASTTBC for $367.50 (application
fee of $250.00 and stamp fee of $100.00 plus GST). We also accept Visa, Mastercard or
American Express.
The annual renewal fee for registration as a “Registered Onsite Wastewater Practitioner” is
$415.00 (plus GST). The billing period for annual renewal fees is from June 1st through May
31st.
For current Applied Science Technologist (AScT.) or Certified Technician (CTech.) annual
renewal fees will be $220.00 (plus GST).
Before completing your Application for Registration, please read
carefully the instructions on the Application Form.
In order to process your Application in the most expeditious manner, please ensure that all the
requested information is provided and is submitted in the format suggested.
All AIT/TILMA Inter-Provincial Transferee applications are reviewed by the Registrar who will
determine the registration to be awarded.
If you have any questions please feel free to call Julie Li, Coordinator, Technical Specialist
Registrations at 604-585-2788, ext. 249 or by e-mail at [email protected].
TILMA / AIT Inter-Provincial Transferee
Registered Onsite Wastewater Practitioner Application Form
Instructions
Complete this application form, attach the required documentation, and forward the completed form and
applicable transfer fee, as noted on the cover letter, to ASTTBC at the address provided on the back of this
form. This information is confidential except as required by law. It will be used for internal administrative
purposes and assessment of qualifications.
Please Note: You must be a member in good standing in the province in which you are registered and in the
categories you are applying for before a transfer of membership will be accepted. You must also successfully
pass a Jurisprudence Examination, and, once registered, successfully complete a Practice Assessment as set
out in the OWRP Policy. Applicants are expected to meet the language requirements in British Columbia.
General Information
Please print or type in blue or black ink
Name Mr. Mrs.
Ms. Miss.
(Legal Family Name - required)
(Legal Given Name - required)
(Preferred Name - optional)
Contact Information
Address
Postal Code
Home # (
)
Work # (
)
Fax #
)
Cell #
(
)
Email:
Pager # (
)
Office use only
Birthdate:
(
Date received:
Receipt No.
(yy/mm/dd)
Birthplace:
Citizenship (copies of Canadian identification enclosed)
Canadian
Permanent Resident
If permanent resident please include a copy of Landed Immigrant Status documentation ‘Record of
Landing’;
Canadian Passport and Canadian Birth Certificate; or Provincial Driver‘s License and Citizenship Card; or
Passport; or
Other government photo identification and Birth Certificate.
Certification / Registration Information
I am currently a
in the Province of
Membership #:
Do you wish to
maintain
terminate your membership in the Province of
upon completion of your transfer to ASTTBC in British Columbia.
Have you ever been a member of another Applied Science / Engineering Technology Society or Association in a province of Canada?
Yes
No
If yes, indicate the Province:
Date:
Membership classification:
Membership #:
I understand that for the transfer to take effect, a copy of my license or certificate along with a letter attesting
to my good standing from the certifying authority in my Province of origin must be provided to ASTTBC. I
also understand that I will be subject to Practice Assessment once registered. Note: French language documentation must be accompanied by a certified English translation.
I hereby certify that the information supplied by me on this form, including attached documents, is true
and correct to the best of my knowledge. In making application for certification, I also agree to abide by
the Sewerage System Regulation and the Standard Practice Manual, along with the ASTTBC Act, Regulations (By-Laws), Code of Ethics, Practice Standards and disciplinary policies as established from time to
time by the Council of ASTTBC.
Signature of Applicant
Date
Refer to cover letter for current application fees.
Payment:
VISA
VISA/MasterCard
MasterCard
Cheque (payable to ASTTBC)
Expiry Date
10767 – 148th Street, Surrey, B.C. Canada V3R 0S4
Telephone: (604) 585-2788 • Facsimile: (604) 585-2790
E-mail: [email protected] • Web Site: owrp.asttbc.org
THIS APPLICATION FOR STAMP MUST ACCOMPANY YOUR REGISTRATION FOR
REGISTERED ONSITE WASTEWATER PRACTITIONER
Once your application is reviewed and if registration is approved, ASTTBC will produce your personal stamp.
APPLICATION FOR STAMP
Registered Onsite Wastewater Practitioner – ROWP #OW________________
(to be entered by staff)
NAME:_________________________________________
(Family name)
_____________________________
(First Name)
ADDRESS:______________________________________
(Street No. and Name, Box, etc.)
________________________________ ___________
(City and Province)
(Postal Code)
PHONE: Home:____________________ Business:______________________
_____________
(Initial)
E-Mail:____________________
* Please PRINT your name on the line below as you wish it to appear on your stamp
Name on your stamp:____________________________________________________________________________
* Please SIGN your name on the line below as it will appear when signing your stamp
Name on your stamp:____________________________________________________________________________
DECLARATION: I agree to only apply my stamp to works and services provided by me or under my supervision
that is in the category of Registered Onsite Wastewater Practitioner (ROWP) in which I have been certified, and
which meets all requirements of the ASTTBC Code of Ethics.
The charge for a member seal or stamp is a lease fee for an indefinite period, provided you remain in good
standing with ASTTBC. This seal or stamp remains the property of ASTTBC and must be returned promptly at
the request of the Registrar of ASTTBC.
Should a new stamp be required, payment for the stamp must be received prior to ordering the new stamp. In
addition, the old stamp must be received by ASTTBC before the new stamp will be ordered.
Should your stamp become misplaced or lost, ASTTBC will require a notarized affidavit (at the Practitioner’s
expense) as to its disposition, as well as, prepayment of the new stamp is required before the new stamp will be
ordered.
By your signature below, you agree to these conditions and any further modifications to these terms as may be
determined from time to time by the Council of ASTTBC.
___________________________________________________
Name (Print full name)
___________________________________________________
Signature
Karen/Forms/OWRPstampapp
Revised – February 2006
_________________________________
Date
GST NO. R106719081
PRIVACY STATEMENT…
ASTTBC safeguards all information provided to the Association by applicants and members.
This information is confidential except as required by law.
Details that are solely related to determining certification level (eg. Educational qualifications,
employment history, references) will be used for internal administrative purposes and assessment
of qualifications.
ASTTBC uses contact information to send registrants information that, in our opinion, could be
beneficial to a significant portion of the membership (e.g. professional practice, recognition,
careers and group services for members). ASTTBC does not sell or trade the mailing list of
registrants. Information on member services that are offered by third parties is only sent from
ASTTBC pre-approved affinity partners and only with prior permission from ASTTBC and is
done under terms of strict confidentiality.
ASTTBC posts to our web site registrant information that in past years was published in our
annual directory. The publication of at least this minimum of information for all registrants is a
requirement of the ASTT Act.
You may choose to opt out of receiving information from ASTTBC, except that information
directly relating to your registration. Examples would be your Annual Invoice, Notice of the
Annual General Meeting or other information directly relating to your certification and
responsibilities under the ASTT Act & Regulations. Opting out may require you to proactively
visit www.asttbc.org for other information concerning Association business. In the meantime
please indicate your preference to the options listed below.
Please check the appropriate box if you wish to be excluded from receiving the following:

No 3rd Party Mailings
No Broadcast Emails
No E-News (ASTTBC Newsletter)
If you have any questions or concerns, please visit the ASTTBC website at www.asttbc.org
or e-mail: [email protected].
I have read and understood ASTTBC’s privacy policy and wish to receive all Association
correspondence.
Name (In Print) ________________________________________________________________
Signature ________________________________
Date _________________________
10767 – 148th Street, Surrey, BC Canada V3R 0S4 • Telephone (604) 585-2788 • Facsimile: (604) 585-2790 • E-mail: [email protected]
Web: www.asttbc.org