Become A Full Consulting Member

APPLICANT DETAILS

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First Name *

Last Name

Preferred Address (will be published on the AIDGC website) *

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State *

Post Code *

Postal Address (if different to above)

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State

Post Code

Employer *

Position *

Telephone – Business *

Telephone – Home (in case your employment changes) *

Telephone – Mobile *

Email *

I enclose the following supporting documentation

Evidence Of Qualifications
Evidence of Relevant Industrial Experience
I Undertake to Supply Supporting Documentation When Requested by the Examination Panel

NOMINATED SUPERVISOR

For supervised exam

Supervisor Name

Supervisor Email

Address

Address Line 1

Address Line 2

City

State / Territory

Postal

Country

Date / Time

Date

Time

Membership Grade Applied For

Consultant

Member to Be Examined for

A - Regulations & Risk Assessment

All candidates must undertake Part A Assessment on regulations and risk assessment (Only Once) Untick if previously assessed

$150.00
B - Group 1

LPG & Class 2

$100.00
C - Group 2

Class 3 & Class 4

$100.00
D - Group 3

Class 5.1 & 5.2

$50.00
E - Group 4

Class 6.1, Class 8 & Class 9

$50.00
F - Group 5

Transport

$100.00

Note : Members may choose to undertake assessment in any or all groups.

I hereby apply to become a member of the Australasian Institute of Dangerous Goods Consultants Inc in the grade of Membership nominated above. In the event of my admission, I agree to be bound by the Rules, By-Laws, Code of Ethics and Code of Conduct of the Institute and pay any membership fees, for the time being in force.

I have not been formally required to justify my conduct to any professional association or regulatory authority except as follows.

Upload Signature

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Applications Signature

Date / Time *

Date

Time

Upload supporting Documents

Click or drag files to this area to upload. You can upload up to 6 files.