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APC1S/QS (2009)

Suite 801, Jardine House, 1 Connaught Place, Central, Hong Kong Tel.: 2526 3679 Fax: 2868 4612

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* * CANDIDATES DECLARATION * *

I have recently changed my Employer / Supervisor / Counsellor *.

I wish to continue with my Assessment of Professional Competence in Quantity

Surveying.

If I shall change my Employer/Supervisor/Counsellor again, I will submit a further

notification on Form APC1S/QS.

I understand that any undue delay in such submission may prejudice my approved

period of professional training.

I declare that to the best of my knowledge the statements and information given onthis form are true and correct.

I understand that any misrepresentation on this form will render my application for

APC null and void.

RECORD OF EMPLOYER / SUPERVISOR / COUNSELLOR SINCE APPLYING FOR APC

Period

From(dd/mm/yy)

To(dd/mm/yy)

Employer Supervisor Counsellor

Date of Notification Signature of Candidate

* Delete whichever is inapplicable.

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APC1S/QS (2009)

Suite 801, Jardine House, 1 Connaught Place, Central, Hong Kong Tel.: 2526 3679 Fax: 2868 4612

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* * NEW EMPLOYERS DECLARATION * *

New Employing Organization Nature of Business

Address of Head Office

Job Title of candidate Date of Appointment/ /

day month year

Address at which the candidate is employed Office Telephone No.

I have read the relevant Rules and Guide.

I support this candidates application to enter the Assessment of ProfessionalCompetence in Quantity Surveying.

I am / We are able to provide the full spectrum of professional training as required.

I / We undertake to provide the candidate with opportunities to practise in the

training areas marked X in the boxes below:

1Measurement andDocumentation

2Estimating and Pricing

3Pre-contract CostPlanning and Control

4Procurement Strategy

5Tendering Process

6Contractors Tendering

and Cost Control 7

Contract Administration 8

Optional Competencies

The candidate is / will be engaged in the following duties:

We have / do not have * professional Quantity Surveyors in our organization.

I am authorized to make the statements and provide the information above.

I declare that to the best of my knowledge the above statements and information

are true and correct. I understand that any misrepresentation on this form will render the candidates

application for APC null and void.

Date Name and Position of Signatory Signature Company Chop

* Delete whichever is inapplicable.Note: You must complete Page 4 (Supervisor and Counsellors declaration) if you have changed your employer.

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APC1S/QS (2009)

Suite 801, Jardine House, 1 Connaught Place, Central, Hong Kong Tel.: 2526 3679 Fax: 2868 4612

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** NEW SUPERVISORS DECLARATION **

I am working in the same organisation as the candidates.

I am / am not * a professional Quantity Surveyor.

Name of In-house Supervisor Qualifications/HKIS No.

Correspondence Address of Supervisor Contact Telephone No.

Position of In-house Supervisor Signature of Supervisor

* Delete whichever is inapplicable.

NOTE: If the Supervisor is not a qualif ied Quantity Surveyor, please ensure that adequateand suitable quantity surveying training is given to the candidate and the Counsellorshould be consul ted as frequently as possible in this respect.

** NEW COUNSELLORS DECLARATION **

I am a corporate QS member of the Institute of not less than 5 years standing.

Name of In-house / External *Counsellor

Qualifications Month & YearQualified/HKIS No.

Company of Counsellor Position of Counsellor Contact Telephone No.

Correspondence Address of Counsellor Signature of Counsellor

* Delete whichever is inapplicable.

NOTE: The Supervisor and Counsellor can be the same person.April 2008. Edition