Saskatchewan Association of Medical Radiation Technologists

I certify that I am of good character and will practice the profession of medical radiation technology with decency, honesty and integrity and that I have no personality or character trait or disability that could affect my ability to practice the profession safely. I further declare that the statements made by me in this application and contained in any documents relating to this application and provided by me or at my request are complete and accurate. I acknowledge and understand that any false or misleading statement, representation or declaration in or in connection with my application, whether by commission or omission, may be cause for revocation of my registration. I undertake to adhere to The Medical Radiation Technologists Act, 2006 and the Bylaws of the Saskatchewan Association of Medical Radiation Technologists (SAMRT) and to notify the association within 30 days of any material change(s) to the information reported by me in this application, and I hereby grant permission to the release of any membership information as approved by the SAMRT Council to verify the statements made and information provided by me. - I so declare and agree

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IEMRT Initial Application