REQUEST FOR WITHDRAWAL
FROM THE ROLL
Instead of printing off the form and filling it in by hand, you can type your information directly into the form and then print it.
IDENTIFICATION
Last name :
First name :
Address :
City :
Province :
Postal code :
Email :
Phone :
Member number (required) :
DECLARATION AND SIGNATURE
I hereby request the Ordre des ingénieurs du Québec to withdraw my name from its Roll of members.
As of* :
Year (YYYY)
Month (MM)
Day (DD)
*Please enter a date that falls on a business day. In addition, please note that we cannot
remove your name from the Roll on a date before the one on which we receive your form.
Check one of the following reasons:
I no longer practice the engineering profession or use the title.
I am retired*.
I no longer work in Québec.
I am currently unemployed.
Other :
*
Retired members can take advantage of reduced membership dues (certain conditions apply). If you would like to know more about this benefit, please
contact the Customer Service at 514 845-6141 before you request to be withdrawn from the Roll.
Please note that annual dues are non-refundable. If you should ever apply for reinstatement, you will have to follow the same procedures that are currently in
effect. This includes paying the reinstatement fee, which currently equals half of the amount of your annual dues. In addition, it will not be possible to reinstate
you as a retired member. In fact, to be eligible for retired member status, members must specifically meet the condition that they "have been continuously registered
on the roll in one or more member categories for the five years preceding the year in which they apply for retired status".
Declaration

I understand that by signing and returning this form, my name will be withdrawn from the Roll of OIQ members. As a result, under section 22 of the Engineers
Act, I will no longer be authorized to use the title of engineer or the abbreviation "Eng." or any name, title or designation that may lead others to believe that I
am an engineer or a member of the OIQ. Likewise, I will no longer be allowed to practice the engineering profession in Québec subject to the penalties
provided by the Act.

I am aware that that due to the removal of my name from the OIQ's Roll, I will no longer be eligible for certain plans offered to all members, including the
professional liability group insurance as well as the insurance plans offered by Manulife Financial. If you have questions about this matter, please
contact Manulife Financial at 1 877 598-2273.

I understand that I will nevertheless be required to comply with the obligation of maintaining a valid professional liability insurance policy for five years after
my last engineering act in private practice under the applicable legislation.

I understand that if I should ever request to be reinstated, I will have to pay the related fees and will still be subject to my professional obligations, particularly
those concerning continuing education.

I agree to send a copy of my transfer agreement, in accordance with the Regulation respecting the cessation of practice of a member of the Ordre des
ingénieurs du Québec. This Regulation does not apply to members who cease to practice their profession when they are employed by a natural or legal
person, a company or a government. An example of a permanent transfer agreement can be found on our Web site under “Media and documentation /
Publications / Annual registration category.” Furthermore, I agree to notify my clients that I am no longer a member of the OIQ.
Signature
Year (YYYY)
Month (MM)
Day (DD)
Please return this duly completed and signed form by e-mail to [email protected], by fax to 514 845-1833 or by mail to the Customer Service.
Ordre des ingénieurs du Québec
Windsor Station – Suite 350
1100 Avenue des Canadiens-de-Montréal
Montreal (Quebec) H3B 2S2
Version 1.5 © Ordre des ingénieurs du Québec
 Phone : 1 877 845-3483 (TOLL FREE)
 Fax: 514 845-1833
Email : [email protected]
 www.oiq.qc.ca
Dernière mise à jour le 27 janvier 2017