Recent Passport Size Photograph APPLICATION FOR ADMISSION TO MEMBERSHIP AS A CA (SINGAPORE) - FOR SINGAPORE QP GRADUATES Full Name: FOR OFFICIAL USE ONLY Date received: Membership no: Cheque no: Approved date: Receipt no: Singapore QP Version 1 Page 1 of 7
SECTION 1 : PERSONAL PARTICULARS Please tick where appropriate Salutation (please delete accordingly): Mr / Miss / Ms / Mrs / Mdm / Dr / Prof / AP First Name: Last Name: Date of Birth: / / (DD/MM/YYYY) NRIC / FIN / Passport No. (please delete accordingly): ID Country of Issue: Nationality: Singaporean Others (specify): Singapore PR: Yes No N/A Gender: Male Female Marital Status: Single Married Others (specify): SECTION 2 : CONTACT AND EMPLOYMENT DETAILS Residential Address: Please tick if you are residing overseas: I declare that I am residing overseas. (Please refer to item 5 of Application Directions ) (City/State) (Country and Postal Code) Mailing Address: Please fill up your mailing address if it is different from your residential address. Same as Residential Address Tel No.: (Mobile) (Office) Email Address: Present Employer: Position Title: Job Level: Board of Directors Senior Management Middle Management Managerial Senior Associate/Senior Executive Associate/Executive/Assistant SECTION 3 : ISCA MEMBERSHIP Are you currently an ISCA Member? Yes No If yes, please select Membership Class: Associate CA (Singapore) Singapore QP Version 1 Page 2 of 7
SECTION 4 : QUALIFICATION a. Academic Qualification Name of Institution: Academic Qualification: Date of Course Commencement: / / Date of Graduation: / / b. Professional Qualification Singapore Qualification Programme Date of Course Commencement: / / Date of Completion of Final Examination: / / SECTION 5 : ACCREDITED TRAINING ORGANISATION (ATO) I have completed my 3-year practical experience with: Name of ATO: (To indicate the name of all ATOs if there is more than 1 ATO) SECTION 6 : WORKING EXPERIENCE In chronological order. Please attach a separate sheet if more space is required. Please specify the period of your employment, with the exact commencement and cessation dates, your job title and a detailed description of your duties. From (Date) To (Date) Company Designation Job Duties From (Date) To (Date) Company Designation Job Duties Singapore QP Version 1 Page 3 of 7
SECTION 7 : TWO CHARACTER REFEREES Must not be immediate family members or close relatives of applicant. a. From a current CA (Singapore) of the Institute of Singapore Chartered Accountants or a full member of an accountancy body recognised by the Institute s Council for membership purpose. I, the undersigned, have known the applicant favourably (insert name of applicant) for years, recommend him or her to membership of ISCA, believing him or her from personal knowledge to be a fit and proper person to be admitted to the membership register. Name: Name of Accountancy Body: Email Address: Signature: Relationship: Membership ID.: Contact No.: Date (dated no more than 3 months prior to the date of application): / / b. From the applicant s present employer such as reporting officer or HR manager. If employed for less than 6 months with present employer, immediate past employer or CA (Singapore)/full member of a recognised professional accountancy body can be considered. I, the undersigned, have known the applicant favourably (insert name of applicant) for years, support his or her application for membership of ISCA, believing him or her from personal knowledge to be a fit and proper person to be admitted to the membership register. Name: Email Address: Reference Type (Please where applicable): Relationship: Contact No.: Present Employer Company Name: Position Title: Immediate Past Employer Company Name Position Title: CA (Singapore) Membership ID: Full Member from Other Professional Body Recognised by ISCA: Membership ID: Name of Accountancy Body: Signature: Date (dated no more than 3 months prior to the date of application): / / Singapore QP Version 1 Page 4 of 7
SECTION 8 : DECLARATION Please answer the following questions by ticking where appropriate. For any Yes, please provide details in the space below. Please attach a separate sheet if more space is required. (i) Have you ever been convicted of any criminal offence? Yes No (ii) Have you ever been adjudged a bankrupt or made an assignment for the Yes No benefit of your creditors? (iii) Have you ever been a subject of any investigation by governmental, statutory or professional in respect of any offence involving dishonesty or any complaint for professional misconduct? (iv) Have you been refused entry to any professional body or have your membership or registration with such body terminated or suspended? Yes No Yes No Privacy and Data Protection Policy The Institute seeks to collect and may use and/or disclose your personal data for matters relating to your membership and/or the conduct of the Institute s business in accordance with the Personal Data Protection Act 2012. The Institute may from time to time use your personal data to inform you of related news, CPE activities, members benefits, goods, services, facilities and events. The Institute may also use your personal data for the conduct of statistical research and studies, and analyse the data collected to administer, develop and improve its services. By accepting membership and/or other goods and services provided by the Institute, you consent to the collection, use and disclosure of your personal data in accordance with the ISCA Privacy and Data Protection Policy. You can withdraw your consent for certain future actions at http://isca.org.sg/consent. Please refer to our ISCA Privacy and Data Protection Policy for more information. I declare that the information provided in this application is true and to the best of my knowledge and belief. I understand that any false or misleading statement in this form could lead to disciplinary action being taken against me and/or may invalidate any decision reached on this application. I shall observe and abide by the Rules and Regulations of the Institute if I am admitted as a member of ISCA. Signature: Date: / / Singapore QP Version 1 Page 5 of 7
SECTION 9(A) : CA (SINGAPORE) MEMBERSHIP FEES FEE PAYABLE FOR APPLICATION SUBMITTED BEFORE 1 MAY AND AFTER 1 NOV Fees including GST (S$) New CA (Singapore) Applicant* Existing Associate Admission Fee 428.00 321.00 Annual Subscription 299.60 149.80 Total 727.60 470.80 FEE PAYABLE FOR APPLICATION SUBMITTED ON OR AFTER 1 MAY AND BEFORE 1 NOV Fees including GST (S$) New CA (Singapore) Applicant* Existing Associate Admission Fee 428.00 321.00 Annual Subscription 149.80 74.90 Total 577.80 395.90 * For existing CA (Singapore) who has been admitted under the Transitional Arrangements and has renewed the annual membership for the current year, no additional fee is payable. This amount is applicable only if the applicant is an Associate (ISCA) and has already renewed the annual membership for the current year. SECTION 9(B) : PAYMENT a. Enclose a crossed cheque/bank draft in Singapore dollars (Cheque No: ) made payable to Institute of Singapore Chartered Accountants. Or b. I, hereby authorize Institute of Singapore Chartered Accountants to charge to my credit card of which the details are given below. Credit Card: VISA MasterCard AMEX Credit Card No: - - - CVV No: CVV is a security feature to help verify that an individual is in possession of the credit card. For Visa/Mastercard, it is the last 3 digits at the back of your card. For Amex, the 4-digit CVV number is printed on the front of the card above the card account number. Card Expiry Date: / (MM/YY) Cardholder s Name: Cardholder Signature: Amount: S$ Singapore QP Version 1 Page 6 of 7
APPLICATION DIRECTION 1. Application will only be processed if the application is duly completed and signed, with all supporting documents attached. Kindly ensure that you have included the certified true copy* of the following documents: a. NRIC b. Academic Certificate c. Academic Transcript d. Singapore QP Graduation Certificate e. Current Employer Testimonial f. Deed Poll (if applicable) *Certified True Copy - All photocopied/scanned documents are to be certified true copies by a CA (Singapore) or a full member of an accountancy body recognised by the Institute s Council. The name, NRIC and membership number of the person certifying must be given in capital letters below the signature. 2. The original or certified true copy of your current employer testimonial should cover your working experience up to 1 month prior to the date of your application. The testimonial should be presented on the company s letterhead, specifying the period of your employment, with the exact commencement and cessation dates, your job title and a detailed description of duties. 3. If applicable, include certified true copy of your deed poll if the name on your documents is not the same as that on your application form. 4. Send your original application form and all necessary documents and appropriate fees to: Member Services Department 60 Cecil Street ISCA House Singapore 049709 5. Goods & Services Tax (GST) will be applicable for members residing in Singapore. For zero-rated GST to apply, members residing overseas must tick to declare that they are residing overseas at the Personal Particulars section. For non-declaration, standard rated GST will apply. 6. For enquiries, please contact officers from the Institute s Member Services Department at 65-65975533 or email: membership@isca.org.sg. Singapore QP Version 1 Page 7 of 7