Declaration of Retirement

If you prefer to submit your application in hard copy by post, please download and print this application form instead of filling out the online form below.

* denotes a required field

Declaration of Retirement
Name*
Title First Last
Email*
Member number*
Member since*
*
- As an active member of the Society since the date above, I do hereby in accordance with By-Law 17, request a reduction in annual membership renewal fees. I will continue to be subject to the annual designation / provincial membership assessment of the Canadian Council of Technicians and Technologists (CCTT).
*
- I am now permanently retired from active participation in the workforce.
Effective date*
MM slash DD slash YYYY
*
- Should I again be employed I am liable, and will pay, the remaining applicable annual membership fees
Signature*
(please type your name)
Today’s date*
MM slash DD slash YYYY