Form J3 (03/04/2013) ENGINEERING COUNCIL OF SOUTH AFRICA Private Bag X 691 BRUMA 2026 Tel: (011) 607-9500 Fax: (011) 622-9295 E-mail: engineer@ecsa.co.za Website: www.ecsa.co.za RE- REGISTRATION LIFTING MACHINERY INSPECTOR AS A Name of Referee Date Address: Dear Sir/Madam I have applied to the Engineering Council of South Africa for re-registration as a Registered Lifting Machinery Inspector and hereby request you to provide the Council with your evaluation of my experience and capabilities, on the basis of your personal knowledge thereof. Please use the attached Forms J4.1 & J4.2 and consult the guideline for referees (Sheet J4). In making this request to you I acknowledge that the information which will be supplied by you to ECSA is of a confidential nature and that I have no right thereto. Your co-operation and early despatch of the document direct to the Council would be appreciated, as it would expedite the processing of my application. Thank you in advance for your co-operation. Yours faithfully ………………………………………….. Signature of Applicant Name of Applicant (Please print) Address: __________ Postal Code: Telephone No: Cell No:
(03/04/2013) Form J3 ENGINEERING COUNCIL OF SOUTH AFRICA Private Bag X 691 BRUMA 2026 Tel: (011) 607-9500 Fax: (011) 622-9295 E-mail: engineer@ecsa.co.za Website: www.ecsa.co.za RE- REGISTRATION AS A LIFTING MACHINERY INSPECTOR Name of Referee Date Address: Dear Sir/Madam I have applied to the Engineering Council of South Africa for re-registration as a Registered Lifting Machinery Inspector and hereby request you to provide the Council with your evaluation of my experience and capabilities, on the basis of your personal knowledge thereof. Please use the attached Forms J4.1 & J4.2 and consult the guideline for referees (Sheet J4). In making this request to you I acknowledge that the information which will be supplied by you to ECSA is of a confidential nature and that I have no right thereto. Your co-operation and early despatch of the document direct to the Council would be appreciated, as it would expedite the processing of my application. Thank you in advance for your co-operation. Yours faithfully ………………………………………….. Signature of Applicant Name of Applicant (Please print) Address: __________ Postal Code: Telephone No: Cell No:
2J_ECSA_LMI_ReRegistration_Appform.docx