MPPI Log Book Form

This form is required for Full Membership status and may be duplicated as required. 
Please type.
Manitoba Professional Planners Institute
2nd Floor 137 Bannatyne Avenue Winnipeg, MB R3B 0R3

 
Candidate Information
Mr./Ms. Surname First Name Initial
Employer Title
 Address of Employer Postal Code Phone Fax
Experience Description
In consultation with the membership committee, a candidate may choose to complete one description sheet per project, one sheet per calendar year, or one sheet for each sphere of activity.
Name or title of experience/project:
Location:
Scale:

(building Group, municipality, region, etc.)

Process(es):
(analysis, projections, design, program development, research, etc.)
Subject:
(physical planning, economic planning, resources, research, etc.)
Year of occurrence
and duration:
(duration in months, # days spent on project, yearly summary, etc.)
Reporting relationship:

(member of team, report to senior, client directly, etc.)
Relationship of experience to public policies or programs:
Description of Duties Performed
Describe accurately the work which you have personally done, indicating your specific degree of responsibility for work which was carried out jointly with others, and indicating the relationship of this work to the definition of responsible professional planning practice.
Certification
Signature of Applicant:
Date:
Validation by Full Member of CIP
As a professional superior / colleague to this candidate at the time of the work experience, I hereby confirm the foregoing description.
Signature of supervising/
colleague member:
Date:
Print name of supervising/
colleague member: