Use block letters or typewriting, and addition sheets as required. Personal Details Name Date of Birth Mailing Address . . Postcode Telephone Fax Business Details Business Address . Use separate sheet if necessary. . . . . . . If the nature of the duties and level of responsibilities are not self-evident from the titles of the position, please enlarge separately.
More detail is desirable about recent years than earlier years. . . . . . .
Describe particular inventions, and new or improved processes or products. Professional Activities within RACI Specify all service to RACI as an office-bearer, member of Council, Branch, Group, Section, Division or other Committee. Other Professional Responsibilities Specify any other contributions or responsibilities of a professional nature not covered above. Use separate sheet if necessary. . . . . . . Declaration I, of do solemnly and sincerely declare that while a member of The Royal Australian Chemical Institute I will observe the provisions of the Royal Charter and By-laws thereof, and will conduct myself honourably in the practice of my profession and to the utmost of my power will maintain the dignity and welfare of the Institute.