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APPLICATION FOR CERTIFIED ACCOUNTING TECHNICIAN (CAT) STATUS This orm should be completed i you satisy the exam, Foundations in Proessionalism and experience requirements to qualiy or Certifed Accounting Technician (CAT) status. Please provide Title (Mr, Mrs, Miss, Ms, or please speciy i other) First/Western name (see examples opposite) Last name/Family name (see examples opposite) Home address Town or city County or state Mobile telephone number Country code No I would like to receive general updates rom ACCA by SMS text message. I would like to receive notifcation o my results by SMS text message. I you choose this option you will not receive your results via email. Telephone number, including area code (eg +44 (0)141 582 2000) Country code Area code No Post/Zip code Country Date o birth Male Female 2 PERSONAL AND ADDRESS DETAILS EXAMPLES: Chinese names Insert your ull name in the Last name/Family name box. Western names should be inserted in the First/Western name box. First/Western name MARY Last name/Family name CHAN YIN YEE Muslim names Insert your ull name in the Last name/Family name box, leaving the First/Western name feld blank. First/Western name Last name/Family name MOHAMED AHMED SALIM  ACCA will not c harge or the SMS service. Please confrm your email  address. Email address (eg [email protected]) 1 EMAIL ADDRESS January 2013 V1 Please make sure the email address is unique i.e. not used by anyone else and written in BLOCK CAPITALS. It is your responsibility to ensure that your email address is correct. ACCA will not accept responsibility or emails being sent to addresses which are no longer used, incorrectly ormatted or which are publicly available. ACCA will send you email confrmation o your registration and passcode details separately ater your application has been processed. I you are accepted as a Certifed Accounting T echnician (CA T) you will receive a qualiying Certifcate and will be entitled to use the designatory letters CAT . You will also have the option to progress onto the ACCA Qualifcation and commence studies rom paper F4 onwards o the Fundamentals module (please reer to Section 8). Registration number Date o registration

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APPLICATION FOR CERTIFIED ACCOUNTING

TECHNICIAN (CAT) STATUS

This orm should be completed i you satisy the exam, Foundations in Proessionalism and experience requirements to qualiy orCertifed Accounting Technician (CAT) status.

Please provide

Title (Mr, Mrs, Miss, Ms, or please speciy i other)

First/Western name (see examples opposite)

Last name/Family name (see examples opposite)

Home address

Town or city

County or state

Mobile telephone number

Country code No

I would like to receive general updates rom ACCA by SMS text message.

I would like to receive notifcation o my results by SMS text message. I you choose thisoption you will not receive your results via email.

Telephone number, including area code (eg +44 (0)141 582 2000)

Country code Area code No

Post/Zip code Country

Date o birth Male Female

2  PERSONAL AND ADDRESS DETAILS

EXAMPLES:

Chinese names

Insert your ull name in the

Last name/Family name box.

Western names should be

inserted in the First/Western

name box.

First/Western name

MARY

Last name/Family name

CHAN YIN YEE

Muslim names

Insert your ull name in the

Last name/Family name box,

leaving the First/Western name

feld blank.

First/Western name

Last name/Family name

MOHAMED AHMED SALIM

 ACCA will not charge or the

SMS service.

Please confrm your email address.

Email address (eg [email protected])

1  EMAIL ADDRESS

January 2013 V1

Please make sure the email address is unique i.e. not used by anyone else and written in BLOCK CAPITALS. It is your responsibilityto ensure that your email address is correct. ACCA will not accept responsibility or emails being sent to addresses which are no longerused, incorrectly ormatted or which are publicly available. ACCA will send you email confrmation o your registration and passcodedetails separately ater your application has been processed.

I you are accepted as a Certifed Accounting Technician (CAT) you will receive a qualiying Certifcate and will be entitled to use thedesignatory letters CAT. You will also have the option to progress onto the ACCA Qualifcation and commence studies rom paper F4onwards o the Fundamentals module (please reer to Section 8).

Registration number Date o registration

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3  ADDITIONAL SUPPORT

4  EMPLOYMENT DETAILS 

Do you have any additional needs which might:• affect your exams and for which you require support from ACCA?• affect any service or facility offered by ACCA for which you may require support?

I you wish to notiy ACCA o any such condition, please confrm by placing a cross in the box and enclose supportingmedical documentation with this initial application. It is important to note that some acilities require signifcant time to makearrangements prior to an exam.

Job title (please speciy)

Employed Sel-employed Unemployed Career break Studying

Company name

Employer address

County or state

Town or city

Post/Zip code Country

Business telephone number, including area code (eg +44 (0)141 582 2000)

Country code Area code No

Public Practice Industry/Commerce Public Sector

Please confrm your current

employment status.

Please note: An ACCA student

may only undertake work as

 set out in ACCA membership

regulations. You may not hold

 yoursel out to be in Public

Practice. I you do not comply

with ACCA regulations we may

be orced to take disciplinary

 action against you.

I you provide accounting

 services, or would like

inormation about the types o 

work you can undertake, you

must contact ACCA on

+44 (0)141 582 2000

or email:

 [email protected]

What employment sector do

 you work in?

5  PREFERRED CONTACT ADDRESS

XHome Address XEmployer Address

Please confrm the address to

which ACCA communications

 should be directed.

6  OTHER PROFESSIONAL ACCOUNTANCY QUALIFICATIONS

X I you hold a proessional accountancy qualifcation which gives the right to practise in your country o residence, please

confrm by crossing this box.

For urther details please reer to Membership Regulation (MR) 8(2) o the ACCA Rulebook at

www.accaglobal.com/members/proessional_standards/ethics/rulebook

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7  PRACTICAL EXPERIENCE

Certifed Accounting Technician practical experience requirementsPlease tick the appropriate box to indicate the route by which the CAT experience requirements have been met.

Foundations in practical experience requirements (FPER)**Please indicate below i you are claiming exemption rom any o the ollowing papers based on FPER:

FA1 MA1 FA2 MA2

ACCA/FCCA Member

Other (please supply relevant supporting documentation)

8  TRANSFER TO THE ACCA QUALIFICATION – i you are currently an ACCA Qualifcation Student go straight to Section 9.

As a Certifed Accounting Technician you will be eligible or transer to the ACCA Qualifcation and awarded exemptions rom the

Knowledge module (F1-F3). No ee will be due or these exemptions, however, ACCA Qualifcation students will be subject to the usual

annual subscriptions, urther exemption and exam ees.

I you are resident in any o the ollowing countries you will be transerred to the Joint Exam Scheme currently in operation. The localbody will contact you regarding any ees due to them.

Barbados, Belize, Botswana, Cambodia, Cyprus, Greece, Guyana, Jamaica, Lesotho, Malawi, Malta, Sierra Leone, Swaziland,Trinidad & Tobago and Vietnam.

ACCA’s Global Practising RegulationsThe ollowing restrictions apply to individuals who are eligible to receive exemptions and subsequently wish to apply or an ACCA

practising certifcate and audit qualifcation. Students who are eligible to receive exemption rom all 9 papers at the Fundamentals

level must complete the remaining Proessional level papers within 5 years o registration and must also pass optional paper P7

(Advanced Audit & Assurance). Students who are eligible to receive exemption rom any papers at the Fundamentals level on the

basis o qualifcations gained more than 5 years previously at the time o the award must or eit all o these exemptions and sit thecorresponding ACCA exams. This applies to exemptions awarded ater 1 January 2010.

I wish to be transerred to the ACCA Qualifcation.

9  EDUCATIONAL DETAILS/COURSES/QUALIFICATIONS – applicable to ACCA Qualifcation Students.

I you do not currently meet the exam requirements these can be met by either passes/exemptions rom the Knowledge module, i.e. F1,

F2 and F3 plus any two additional papers rom F6, F8 or F9 in the Skills module or by holding a recognised qualifcation.

10  BSC (HONS) DEGREE FROM OXFORD BROOKES UNIVERSITY  

Applicable i you wish to transer to the ACCA Qualifcation

ACCA’s innovative partnership with Oxord Brookes University allows ACCA students to study or a BSc (Hons) Degree in Applied

Accounting, while taking their ACCA exams. On completion o the Fundamentals Level o the ACCA Qualifcation and the Proessional

Ethics Module, students are eligible to submit a Research and Analysis Project to Oxord Brookes in order to be assessed or the degree.

You will automatically be considered or inclusion into this programme unless indicated below.

Your details will be held on a joint system.

Please note: You must hold an acceptable English language qualifcation. I you are awarded exemptions rom papers F7, F8 or F9,

or your exemptions are based on qualifcations gained by you more than 10 years ago, you will not be eligible to join the degreeprogramme. Previously registered ACCA Qualifcation students transerring back to the ACCA Qualifcation will have their Oxord Brookes

eligibility assessed on an individual basis, in accordance with current regulations.

I do NOT wish to be included in the ACCA/Oxord Brookes University programme to obtain a BSc(Hons) Degree in Applied

Accounting. I understand that I can opt in at a later date and that I must opt in prior to attempting papers F7, F8 or F9.

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12  COMMUNICATION AND MARKETING

This section sets out certain inormation and options on how ACCA may communicate with you, the types o materials which ACCA

may send to you and the extent to which ACCA will discuss your details with certain third parties. By signing the declaration, you give

your consent to ACCA using your data or the purposes and in the manner indicated in this section, except to the extent you opt out

below or by logging into myACCA.

Communications methods – ACCA may communicate with you by email, phone or by post using the contact details provided on this

orm or otherwise provided by you. Email is ACCA’s preerred method o sending general correspondence, publications and promotional

inormation.

ACCA promotional material – In order to assist you with your studies and help you to get the maximum beneft out o your course and

ACCA’s services, ACCA may send you promotional materials relating to ACCA services and events.

ACCA support – ACCA oten communicates with employers to discuss membership improvements and ways in which ACCA can

provide enhanced support towards both CPD and advancements through the ACCA Qualifcation. When communicating with employers

it is oten helpul to provide a list o names o those ACCA contacts who are working at that company.

Third party marketing material – ACCA would like to keep you inormed o products and services rom third party organisations that

may be o interest, relevance or beneft to you in your proessional/study capacity. All are strictly vetted and the mailing/email list is

never given directly to the advertising party. All campaigns are carried out by ACCA or an ACCA approved agency.

Data protection

ACCA may use your personal data (provided on this orm or otherwise collected during the course o your relationship with ACCA) in

order to:

• administer your application and any subsequent ACCA membership

• administer and monitor exams, courses and experience (i applicable)

• send you publications and other communications (produced by ACCA)

• respond to enquiries and investigate complaints

• comply with ACCA’s regulatory obligations

For more details on how we collect and use your personal data, please reer to our data protection notice, available atwww.accaglobal.com/documents/protection_notice.pd or alternatively contact ACCA using the details set out at Section 14.

I do NOT wish to receive third party marketing materials.

The ee due or Certifed

 Accounting Technician status

is £80GBP. Once ACCA has

 accepted your application

 your ee will not be reunded.I alse or misleading

inormation is submitted

 your application will not be

 accepted and the ee will be

retained by ACCA to cover 

investigation costs. I your 

 application is rejected on

other grounds, your ee will

be returned to you.

11  METHOD OF PAYMENT

Card number (rom ront o card – do not include spaces, do not include the 3-digit security code on the reverse)

Today’s date Cardholder’s signature

Start date (i shown) Expiry date Issue no. (i shown) Amount payable

Name o cardholder (as shown on card)

Visa American Express MasterCard Maestro

Crossed GBP cheque/bankdrat drawn on a UK bank

Crossed GBP British postal order(s)

Credit/debit card (see below)

Payment can be made by a crossed sterling cheque made payable in the UK, crossed British postal orders, a sterling bank drat drawn

on a UK bank or a credit or debit card. Cheques/bank drats or postal orders or £80GBP should be made payable to ‘The Associationo Chartered Certifed Accountants’. Please print your name and registration number on the back o your payment document(s).

Please do not send cash.

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Signed the declaration (see Section 13)

A passport-sized photograph (or those wishing to transer to the ACCA Qualifcation)

Practical experience requirements documentation (see Section 7)

Copies o all your educational and proessional certifcates including ofcial transcripts and i applicable ofcial translations o 

any non-English documents (see Section 9)

A copy o your marriage cer tifcate or deed poll certifcate or decree nisi i your name has changed

And enclosed the ollowing:

Ensure that you have:

14  HAVE YOU INCLUDED EVERYTHING?

Please read the ollowing careully to ensure that you have sent us everything we need to process your application without delay.Please do NOT send original documents – we are unable to guarantee that these will be returned.

13  DECLARATION

Read terms and conditionsI wish to apply or admission as a Certifed Accounting Technician o ACCA.

I undertake that I will only describe mysel to be a Certifed Accounting Technician and use the designatory letters CAT upon acceptance

o this application.

Important Notice: As a student o the ACCA Qualifcation, you will be liable to disciplinary action under ACCA Byelaws 8 and 11

or events which occurred beore or ater registration on the ACCA Qualifcation and prior to admission as a Certifed Accounting

Technician. Events which merit disciplinary action include, but are not limited to, misconduct (see below); incompetence in perorming

duties o employment; breach o the ACCA Byelaws or Regulations; disciplinary action by another proessional body; bankruptcy or

insolvency; ailure to satisy a judgement debt without reasonable excuse within two months.

Misconduct includes, but is not limited to, any act or deault likely to bring discredit to the student or ACCA or the accountancy

proession. The ollowing are conclusive proo o misconduct:

– conviction or a criminal oence, which is discreditable to the student or derogatory to ACCA or the accountancy proession;

– a fnding by a court in civil proceedings that the student has acted raudulently or dishonestly.

Any event reerred to in ACCA Byelaw 8 must be brought to ACCA’s attention when submitting this orm. Such an event will be taken

into account in deciding whether to admit you but will not automatically preclude you rom being admitted as a Certifed Accounting

Technician. However, ailure to bring such events to ACCA’s attention will make you liable to disciplinary action in your capacity as

a student o the ACCA Qualifcation. A copy o the ull ACCA Rulebook is available or reading online at the ACCA website, at ACCA

ofces, or can be bought rom ACCA. I declare that I have read and ully understand this section. I understand that I must bring to

ACCA’s attention any event (as defned in ACCA Byelaw 8 and summarised above) which occurred prior to the date o admission as a

Certifed Accounting Technician.

I thereore declare that there is nothing I should bring to ACCA’s attention.

I agree that in consideration o ACCA admitting me as a Certifed Accounting Technician and whilst I remain an ACCA Qualifcation

student I will promptly bring to ACCA’s attention any event which will make me liable to disciplinary action under ACCA Byelaws 8

and 11.

I agree to comply with ACCA’s Charter, Byelaws, Regulations and Code o Ethics and Conduct rom time to time in orce.

I declare that I have read and ully understood the declaration. I declare that the inormation given in this orm is correct and I hereby

apply or registration as a Certifed Accounting Technician. I understand that any alse or misleading statement in this orm could lead to

disciplinary action being taken against me and/or may invalidate any decision reached on this application.

Signature D D M M Y Y Y Y Date

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15  WHERE TO SEND THIS APPLICATION

PHOTOGRAPH

Please submit a passport-sized photograph o yoursel with your ull name

written on the back.

Please send your completed application to:

ACCA OPERATIONAL DELIVERY 2 Central Quay 89 Hydepark Street Glasgow G3 8BW United Kingdom

tel: +44 (0)141 582 2000  ax: +44 (0)141 582 2222  email: [email protected]