REPORT BY REFEREE
on
HIGHER MEMBERSHIP APPLICATION
Referee:

Name:		     

Address:	#/Street	     				Suburb      

			State      		Postcode	     		Country      

Dear      	Date:      
Members of the IES wishing to upgrade their membership to a higher grade in the IES: The Lighting Society are required to support their application with a report from 3 Referees nominated by them and who are prepared to act in this role.
I understand from the candidate whose details appear below that you have agreed to act as one of these referees required in conjunction with their application.
The applicant therefore provides you with the attached completed copy of their Higher Membership Application Form, together with this form and a copy of the IES Guide to Membership describing the requirements for an upgrade.
It is requested that you complete the following:
1.	Review the technical particulars of this application and initial only those items given by the applicant that you are able to confirm from your personal knowledge,
2.	Complete the Referee’s Statement on the last page of this letter. This should include descriptive comment on the applicant’s technical ability, but may include any reservations as well as support for the applicant. Please note that it is not a character reference that is being sought, but a professional assessment of the level of knowledge and skill exhibited by the applicant in the relevant lighting fields.
3.	Sign the declaration, and
4.	Return this form direct to me at the address below, complete with all of the enclosed papers, preferably within two weeks of receipt of this request.
The information provided by you will be treated in confidence and used solely for the assessment of the application. While your confirmation of the applicant's record may be advised to the applicant your personal comments will not be communicated to them.

Yours faithfully,
Chapter Secretary
      Chapter

Referee’s Details
Are you an IES member?:	Yes 	No 
Your Grade (if a member):	Associate 	Technician 	MIES 	FIES 
Any other relevant details:
     
Other Academic or Professional Qualifications (please state):
     

Membership and grade of other Professional Organisations (please state):
     
Contact Details:
		hone      				Mobile      

Email     

Applicant’s Details
Name:		Family:     			First & Second Name:     

Home		#/Street	     			Suburb:     
Address:	State:     		Postcode	:     		Country:     

Contact	Phone:     		Fax:     		Mobile:     
Details:	
		Email:     

		Date of Birth:  /  /    	Year Joined IES:    	Present membership Grade      

Return to:
Please return all forms direct to:
Chapter Secretary
IESANZ Ltd
Address:      
State:         				Postcode:      
				
Phone:      				Mobile:       		Fax:      
						
Email:      

Note: All documents are available from the Society’s website at www.iesanz.org

Referee’s Statement
After reviewing the application form I confirm/comment on the following from personal knowledge of the applicant. (Please tick boxes as appropriate)
Applicant’s Name:
		Family Name      			First & Second Names      
			
Education:	Education in Lighting or Allied Sciences		Other Qualifications	
Experience:	Experience in Lighting or Allied Sciences		Other Experience	
STATEMENT:
Please expand and comment on any or all of the following points:
Matters applicable to the applicant’s educational qualifications in lighting and/or for work in allied fields associated with light. In particular, the applicant’s technical experience in these areas of lighting and/or for work in allied fields associated with light; and, if applicable, the applicant’s service within the Society, or offices held in industry: (the following space will accept approximately 250 words)
     
I have known the applicant personally for approximately     years.
I certify that I am satisfied that this applicant has undertaken the education and/or experience in lighting and/or allied fields and other matters claimed in this application, at those items where I have initialled the form.
In addition, after reading the requirements for members to upgrade their standing in the Illuminating Engineering Society as set out in the relevant sections of the IES Guide to Membership, I have given my comments, above, on this applicant.
									  /  /    
Signed	Date
     
Print Name in Full