Australian Capital Territory
Architects (Application for Registration as an Architect in the ACT) Approval 2004
Approval statement for
Approved Form AF2004-10
made under the 
Architects Act 2004, section 92 (Approved Forms)

1	Name of instrument
	This instrument is the Architects (Application for Registration as an Architect in the ACT) Approval 2004.
2	Commencement 
	This instrument commences on the day after notification.
3	Approval
The attached form is approved for the purpose of applying for registration as an architect in the Australian Capital Territory.

	

Cynthia Breheny
Chair
ACT Architects Board
24 June 2004

Privacy
Information

The information you are asked to provide will be used to assess your ability to hold registration as an Architect in the ACT. 

The lawful authority for the collection of this information is the Architects Act 2004. The information may be disclosed to other Architect Registration Authorities. 

Note

For applicants applying for registration that are not registered in another State or Territory complete points 1, 2, 4 & 5.

For applicants applying for registration under Mutual Recognition (registered in another State or Territory) complete points 1, 3, 4 & 5.

For applicants re-applying for registration complete points 1, 4 & 5 and list your previous ACT registration number below your signature.

A1

Application for Registration as an Architect in the ACT

1.Applicant Details

    Surname  __________________________________ Date of Birth __________________
          Given Names  _______________________________________________________________
Residential Address  _______________________________________________________________
		        _________________ Territory/State _________________ Postcode ________
       Postal Address  _______________________________________________________________
 	       __________________ Territory/State _________________ Postcode _______
   Business Address _______________________________________________________________
 	       __________________ Territory/State _________________ Postcode _______
           Home Phone __________________ Business Phone _______________________________
          Mobile Phone __________________ Email ________________________________________

2.Documentary evidence 

Please attach		
certified copies of:

 Qualifications 	   Photo Identification 		 1 x Professional Reference

	 AACA APE Certificate  1 x Personal Reference 	 1 x Passport sized Photo

3.Registration under Mutual Recognition - Documentary evidence

Please attach 
certified copies of:
	
	 Interstate Registration/s	 Photo Identification		

4.Questionnaire

Have you been bankrupt, or are applying to take the benefit of any law for the relief of bankrupt or insolvent debtors, or compounding with creditors or making an assignment of remuneration for the benefit of creditors?  No  Yes

Have you been convicted or found guilty of an offence against the Architects Act 2004 or the Repealed Architects Act 1959?  No  Yes

Have you been convicted or found guilty of an offence against a Commonwealth, Territory or State law punishable by imprisonment for 1 year or longer?  No  Yes

Have you ever had Architects registration disqualified, cancelled or suspended under the corresponding laws of any other State or Territory?  No  Yes

Please attach your passport-sized photo here if required to complete part 2.

5.Declaration

Office Use Only

Received

Approved

Registration no.

If you have answered yes to any of the above questions please provide details: ________________________________________________________________________________________________________________________________________________________________

I declare that all the information contained and attached to this application is complete, accurate and true to the best of my knowledge. I understand that there are severe penalties for providing false or misleading information.

Signature __________________________ Date_____________________

Previous ACT Registration No. (if applicable) _______________________

Payments

NOTE: 	Application fee - $215.00	A4 certificate - $11.40 (GST does not apply)
	
 Please indicate if you wish to pay for and receive the A4 certificate

Cheques should be made payable to the “receiver of public monies”
Please provide your name and address on the back of the cheque.

Payment options

IN PERSON – present your cash, cheque, money order or credit/debit card ($5.00 minimum payment and $2500.00 maximum payment for credit card) at the ACT Building, Electrical and Plumbing Control office, ground floor, north, Dame Pattie Menzies House, 16 Challis Street, Dickson, ACT (8:30 am to 4:30 pm Monday to Friday except public holidays).

BY FAX – complete the credit card details and payment details ($5.00 minimum payment and $2500.00 maximum payment for credit card) then fax it to ACT Building, Electrical and Plumbing Control on fax number (02) 6207 6324 (Bankcard, Mastercard and VISA accepted).

BY MAIL – enclose a cheque or money order or complete the credit card details and payment details ($5.00 minimum payment and $2500.00 maximum payment for credit card) then post it to Licensing Unit, ACT Building, Electrical and Plumbing Control, GPO Box 1908, Canberra ACT 2601.

Payment authority – for fax or mail payments only (see above)

ACT ARCHITECT BOARD ENQUIRIES – Please call (02) 6207 6288, facsimile (02) 6207 6324

Please charge the amount of $ ___________ to the:  Bankcard  Mastercard  Visa of:
Name of cardholder _______________________________________________________________
          Card Number _____________________________ Expiry date ________________________
           Cardholder’s
                 Signature _____________________________ Date _____________________________