@QRics ICS APC Enrolment Form (MENA) Notes to consider before completing this form Plaase ensure that you readldownloed tha most recent gues as they give fl details of the APC requremens, they ae avallable a wry. is.oralape. You must select the APC pathway you wish {ofolom, because itil dfine your pt 0 quaicaon ‘APC candidate's guide ‘APC guide for counsotors CChoson patsy guide (APC SaleAssosemert Form “The APC sutimission document and al the support avaiable throughout your APC are aio found at Jape alr reading tha guides, you sts have questone abou th enrolment Bibtits please contact your Membership Assessment team apemedDries.org tat wil bs happy to eb Period of momberstib ICS regulations state that yu can ony remain candidate of ICS for six years. you have not (uated as a professional member win this tine, Yu wi be contac io ictss YOu progress IS'RICS professional membership. ir you have succossfly completed a work placement as part of your degree please nlude with ‘Jour pplication wien conan from your counselor in oder tous this expertence towards Jour APC. Ths wit need to give the date thet you started and ended te work plcement as well = ‘enfation tat you were working win the APC requirements [AI APC candidates must pay an APC subscription 1 January 31" December (2016 rate) £142.00, fanaa separate £800 APC fee Total amount to be submited is £642.00 ‘Your application will not be compte until you have pad the appropriate Fes, rics.orgVisit our website and pay online 2016) tniesmense event nual subscr Please note: (@Qrics: ‘Subscriptions are tobe paldin ful, tore in pro-rata applicable, When enrolment takes place before 1 October you wil pay the cuent year's subscription in {ultand you wil then be required to pay the flowing year's subscription when this becomes ‘ue, on 7 January ‘When eneolment takes pace after 1 October, your subsziption feo wil ever the period from ‘October to Gecember ofthe current year and allo the flowing year. {Allfees are non-refundable unis you wihdraw your application within a zo0ng of period ‘6f 14 days rom the date your erolments processed by FICS. I you decd to wihraw {our application pisase emall apemed@rics.org ‘Alamounts payable in connection wth the APC are exempt of VAT. IfVAT becomes, fpoticabe aay tin, then RICS reserves the ight to charge applicants VA. Falloning election to professional membership, you willbe required to pay an upgrade fe £450.00, rics.org41. Personal details ICS mombarship number (7 frown Tier ie] Famiiy name: | Thirunavakaresu Forename Theepan Nationaliy= ‘Sankar ‘Telephone Home: 0094776560581 | Moi: O0STarOSSB069 Date of Bir 20- July 1967 mai | theepanast@yahoo.com | Gender aie Ci | Fomaie | Prefer not to say 0 Home address: 35 Point Pedro Road, Valvetttural, Jatina, Srilanka, PosiZip code: County: oun: ‘Country of residenes ‘oar 2. Employment details ‘Company name ‘Quentity surveying Services ‘Company address: Prisma Inemaons Bulg, tet Flor, 80 Seena Stes, Doha, Qatar ater Telephone: Work: 4774672 [[ieeet Lin Mobil:30598069 Email theepangs¢@aol.com Employment stat date orvMaren2013 (Rics rics.orgPlease select your preferred correspondence address (please noe all commnieston wil be ‘Sento this adress) a Home a Business 3, Academie qualifications (Piease provide detals of your academic qualifications) eet Penis eee eee eee ieee cin Quanity Tsp) surveying zoor_| 255992010 | ttine ein Contraction Frojec Management | sep2013_| sep2016 _| stance Leann Please note proof of qualifications vil be required e.g copy of degree cetst enrolment ‘confmation (do not send erginals) 4, Professional membership (Please provide detals of your professional body membership) cee Peer renee peels Incorporated | Actievedindustial experience Chareinsttute of bud Membership | and academic qualfston zou Please note — prot of membership wl be requted e.g, membership confrmaton lee or 3 copy of achievement cetieate 5, APC Pathway Please select your APC pathway below, this defines your path to {qualification and how you wll be primarily assessed. (Please refer to ww.ics oralape for further guidance) (rics: rics.org‘Select one pathway only "a nd twos © __ | Pain ae Bevloment a Bulking Cont [Pris ianagerent a Bulking Suneyig co _ | preety non and a ny SUNS SE Bu nase a _| oun a Conner Proper [Resear a vont [Reston a Facies Management Cima al o Geomatics [Taran Aan co Monegan a (Consultancy a = a Morton Wate = Wao of Basses at 5 Manager! Ione sete 6. Surveying Experience (Please confirm how many years of surveying experience you have, including pre and post qualification experience) Post qualifiation Pro-qualiication experience_| experience ‘otal number of years Year - Years nal experience: “Type anid scope of responsibillies tite Employer Period) Job tt lover | Gn dai ‘Aessant Quanty| Eden Enaneeeng PVT | Quandt take-f, Evaltion of Quotation ans 2007- | Suveyor ue Neral eres, Preparation Bs f Guat 2000 a a ‘Gumriy Survey | case Gonanumion | SUDoOWAGO"s rir pay cricaton zoit. | Project uarny | Cae nd. frat sccout, Proosong commercial Zoe | Saveyor overt estimation of veraton oso a "Vaan Tae Reza n roaicng EOT Zer2 | vey suveyer | Qnty Suneying | calms. Management of Subeontactr, "er | Sorieee (GOSS) | stn Valuation, Fisk ara, rng of ‘der, Coe planing ane Eutge stmting (rics rics.orgCaey —saverG {nd consston 7. Counsellor (Your couneelior must be @ chartered surveyor, but does not have fo work at the same organisation as you) Name: irjan Sahayaratnarajsh ICS Membership Number: | 1221063, er | 8. Disability (i you consider youre dleabled please give further information below) No Any isaisy 9, Declaration {nave road the following and hereby undertake: + To.comy and actin accordance withthe Charter, Bye-Laws, Regulation and Rules of RICS as they now exit, ora they may tho futuro be amended, and ao comply wih such ‘other requirements 2s Governing Council sl determine + To promate the Objects ofRICS as fa as in my power 1 Notat anytime afer casing tobe a member'o use or permit tobe usedn conjunction wth ny name, of name of any organization wth which I may at any te bo aesoriaed, any tesignalion or expression denaling or suggesting memborship or any comecton with RICS 1+ To pay promptly any monies due te RICS, including but not ited to anyfee, subsription, levy arrears, ne & other penal. oF reimbursement in accordance wiany scheme of ‘compensation, orn respect of any goods or serves commissioned by me rom RICS rics.org+ To.declare any criminal convcton within 20 days {That should wish to terminate my membership, o not the Chief Execulve in wing | confirm that have disclosed to RICS ful details of the following where apolicable + any charge oF convcon of a einal fence wher the pena could be Imprisonment, Unless itis now spent convision as provided inthe Rehabltaton of Oflerders Act 1874 or ‘he equivalent In my juecion + any pending cecpinary proceedings or averse fnngs made against me by another regulatory body within the last 3 years ‘+ am not an undlscharged bankrupt ‘+ {have not inthe last trae years been subject fo any insovency proceedings or ther arengement vith creditors In respect of my debs (such as an Insolvency Voluntary ‘Anangemen. It atany time RICS cscovers that you have fled to declose any ofthe above orth you Nave provided fase information I wil have the right to terminate your membership wih immediate effect (oth no further obsgation io refund any subscription or ether fos), | understand and accept that lam accountable forthe truth of this declaration. Confirmation of any iclosues (you wish to sen this information confident then plesse wile {© RICS Regulation, Surveyor Cour, Westwood Way. Coverity, OV4 BIE. UK: THEEPAN THIRUNAVUKARASU Name in ul sions: | Depo ate: | arene 410. Data Protection Act RICS is regltared aa data contol under the tems ofthe Data Protection Act 1988. When you ‘gn the application for, you give consent to the storage and processing of your personal daa by RICS for legitimate purposes, which shal include any Purpose ancilary to er neckssary forthe processing of your applcalon forthe APC/Associate Assessment. This shail incude sharing your fata wih assessors and using ema and applications such as Tun (plagiarism detection software ICS wil use and store your persona information that colcted fom you by us to deal with your ‘enquly and membership requirements For RICS members, your persona iformation willbe used for a) administering your membership including soning renewals, b) sending compulsory communications such as taxe relating tO (rics : rics.orgregulation anc conduc) sending practice and guidance notes, d) AG lformaton, 9) or any father reason elated to your membership and 1) a8 outined in our cookie pokey. For non-members, we wl usa your personal formation toa) deal wth your eng, supply You (ith iformation regarding an ever. conference, taining, product o services as requested, c) ‘manage your preferences and requests and ) 2 eutined in our cookie poy. In order to 6 this we may contact you by email, post, phone or SMS, In providing your personal information, you agree to your personal infomation beng processed by ‘other RICS offces around tha wort forthe purposes sat out inthis notice, inca ofices ouside tthe EEA in counties which are not deemed to have te same level of protection of personal Information. Furthermore, RICS would ke to use the personal information that you hve provid ows in Fotaton the communications described below (including by omailtelephone, where appropriate) Please tick the relevant boxes below: you do not wish to receive addtional communications fom RICS about membership and the profession, tk hore you do not wish to recaive ational communications rom RICS about RIS conferences. ‘eves, progts, services and raining (some af which may complement your FD requremerts), ‘knee For members only, you do not wish ta ooeive atonal communications rom RICS dealing color om bird paris wh whom we ave negliated speck deat for member, tik here lcs would ke to pass your details (nclodng emall address ad phone number) to slectes thd pari pre-approved by ICS eo that thoy can fot you knw trom tm to tre about ir fers, produss ane services, Pease tk here f you do wish to recave commiicatons fom these ‘hired partes by ema by post and by phone (CFor flit of RICS aflated third pary partners vist wavs orlbeneftsoh) Member diversity privacy notice RIGS are ecively monitoring the diversity of ou members to ensure we have a tue understanding fof those working inthe profession. To d his we ae calecing and monitoring ifmation onthe ‘ge, gender disability and ethnic agin ofthe membership. As the data we ae calecting personal data itis collected and held stl in scocdance withthe Data Protectbn Act 1896. This Information wil be used purely fr statistical purposes ad wll ot be passed onb other Crgansations. Please nota you donot have to provide the data request and have the ght to ‘questa copy ofthe personal information RICS holds on you. Ifyou do wish odo soar have ny {qussons regarding RICS diversity monitoring pleace contact RICS Contact Centre on ontactrios@res. ora “The contact between RICS and is members shallbe governed by and construed nal spect in ‘accordance wi the las of England and Wales and the pats revocably agree to submit tothe (rics rics.orgexclusive jufsdiction ofthe cours of England and Wels, irespoctive of any ater factor including (Gut not med to) where a mombor practices as a surveyor. Please select your etic orig — write 1D otmer asian chinese a Inaian Black Cartbean Other etn group Pakistan) = «Black can Bangladeshi Other Black 0 Please return your completed application via emall to apeme@ries.org Please donot include ‘card details with your application. office use only: pssocament: | Pretinnary | Stoawes | 0 | srtz o fst | a isang Pameremetot | payment | © | Cneave a ‘esdemiepreet_| Cl Professional uateatonpoot | RIcs ries.org