Membership Entry Pathways Assessment Form

8/2/2019 Membership Entry Pathways Assessment Form

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1CPA Australia Membership Assessment Application (2011)

Please read these instructions careully

You can enter your details directly into the application orm on your computer and then send us a printed and signed copy.We recommend that you keep a copy or your own records.

What is this application or?

This assessment will help to determine your starting point in the CPA Program and your eligibility or membership.

I you were a previous member and wish to renew your membership

Please contact your local ofce directly. You will fnd a list o our ofces on the CPA Australia website at cpaaustralia.com.au/contact

I you wish to apply or reciprocal membership

CPA Australia has Mutual Recognition Agreements (MRA) with a number o leading accounting bodies around the world. In most cases,

members o these bodies can apply or a reciprocal membership or CPA Program exemptions.You will need to send us an application orm that is specifc to one o our MRAs. Inormation is available on the CPA Australia website at

cpaaustralia.com.au/mra

I you need help or more inormation

You will fnd more inormation about the CPA Program at cpaaustralia.com.au/cpaprogram


Send us your application

There is an application ee or your assessment

There is a non-reundable ee to assess your application. We will contact you about membership i you are eligible to proceed.

We accept applications throughout the year

You can:

mail your application to one o the addresses on page 12, or

bring your application into your local ofce. You will fnd a list o our ofces on the CPA Australia website at cpaaustralia.com.au/contact

Incomplete applications cannot be processed and this will delay your assessment and possible enrolment into the CPA Program.

Membership Entry PathwayAssessment Application

Introduction

Please turn the page to

begin your application

At the end of the formwe will remind you what to

send us and where to send your

documents.
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(A) About you

Your personal details

Title

Mr Mrs Ms Miss Other

Given names

Preerred name

This will be used as your frst name

in our correspondence.

Family name

Date o birth

/ /

D D M M Y Y Y Y

Do we already know you?

Were you a CPA Passport student?

No

Yes My CPA Passport number was

CPA Passport students are not

members o CPA Australia.

Have you previously had a CPA Australia Qualifcations Assessment or membership or migration?

No

Yes My reerence number was

You will fnd this reerence number

on our qualifcations assessment

result letter. I available, please

provide us with a copy o this letter.

! Have you changed your name?

I your name is dierent on any o your transcripts or identity documents, we will need a certiied true copy o a proo o name

change document.

You can prove your name has changed by such documents as a marriage certifcate or government-issued change o name document.

Please ensure that these are certifed true copies o the original documents.

Page 10 o this orm provides inormation about certiying your documents.


Application Form

Ofce use only reerence number:


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Your home contact details

Home address

Suburb or City

State or Province

or Region

Postcode or Zip

Country

Home phone

e.g. +61 3 1234 5678

Please include the country code

and area code.

Mobile/Cell Phone

e.g. +61 3 1234 5678


and area code.

Your employment contact details

! I you are not currently employed, please ignore this section.

Employer name

Position title

Employer address

Suburb or City

State or Provinceor Region

Postcode or Zip

Country

Business phone

e.g. +61 3 1234 5678


and area code.

Business ax

e.g. +61 3 1234 5678


and area code.

Your communication preerences

We need your email address to send your assessment result and other important updates including login details so that you can track the

progress o your application.

Your email address (mandatory) Please ensure that your email

address is written clearly and

is correct.

Which is your preerred postal address?

At work

At home

Please choose oneonly.


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Your eligibility or membership

All o these questions must be answered or your assessment.

Are you currently providing public accounting services in Australia? Public accounting services

include accounting, bookkeeping, auditing and assurance services, taxation, insolvency and

corporate reconstruction, fnancial planning and fnancial reporting.

No

Yes

Public Practitioners:

are subject to regulation

have additional training needs

and responsibilities

In the past 10 years, have you ever been convicted o a criminal oence, notifable oence or are

there any pending charges against you?

No

Yes

Are you or have you ever been a debtor in any Sequestration Order, Deed o Assignment,

Composition or Deed o Arrangement, under the provisions o the Bankruptcy Act?

No

Yes

Are you or have you ever been a Director o a company to which a Receiver, a Provisional

Liquidator, a Liquidator, a Scheme Manager or an Ofcial Manager has been appointed:

while you were a Director, or

within six months ater you ceased to be a Director?

No

Yes

Have you ever been reused membership or had to oreit your membership o a statutory,

proessional or other body?

NoYes

Have you ever been subject to disciplinary proceedings by a statutory, proessional, academic

institution or other body that may have bearing on your proessional capacity?

No

Yes

! I you answered Yes to any o these questions

Please provide more inormation about the nature o your situation on a separate sheet and any related ofcial documentation to

support your application.

I you answered "Yes" to providing public accounting services, please provide details o your role and ownership o the business,

outline services oered to the public and classifcation o the accounting services your business provides.

Attach supporting documents to this application and mail to:

General Manager, Membership

CPA Australia Ltd

GPO Box 2820

Melbourne VIC 3001

AUSTRALIA

Your application will be considered individually on its merits and may take longer to process.


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(B) Conirm your identity

We need you to confrm your identity by sending us certifed true copies o your identity documents. Use the list below to score a

minimum o 100 points o identity confrmation. The identifcation should not be expired.

Proo o your identity

3 Type o identifcation Your score

Birthcertifcate Earns you 70 points

Citizenship certifcate Earns you 70 points

Passport Earns you 70 points

National Identity Card

Issued in Hong Kong, Malaysia, Singapore and PRC etc.Earns you 70 points

A written reerence

From a ull member o a recognised proessional body

This reerence must: be signed and dated by the reeree show that you have known the reeree or at least 12 months

Reerences must not be dated more than three months prior to the application being received by us

Earns you 50 points

Licence or permit issued under law (with your name on it)

This must also show your signature or photo (e.g. a drivers licence)Earns you 40 points

Public Service ID card (with your name on it)

This must also show your signature or photoEarns you 40 points

Social Security ID card (with your name on it)


Tertiary student ID card (with your name on it)


Medicare card

This is not a private health care cardEarns you 25 points

Credit or other bank cards

You can use more than one card (each or 25 points) but each card must be rom a dierent bankEarns you 25 points

Your total score

Must be at least 100 points

! You need to send us certiied copies o these identity documents

Each identiication document must be a certiied true copy o the original as described on page 11.

I your name is dierent on any o your identity documents, you will also need to send a copy o your proo o name change document.


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Provide profle inormation

3 Tick one box only or each o the ollowing

1. Current employment sector

Academia/Education Public Practice (not public sector) Parenting (Go to Point 6) Small to medium enterprise ($50m turnover) Government Commonwealth/National Government State/Territory Government Local Government Business Enterprise Not-For-Proit Not employed (Go to Point 6) Retired

2. Industry

Hospitality Finance and Banking Insurance Financial Services Government Admin/Deence Health/Community Services Printing/Publishing/Recording Oil/Petroleum Agriculture/Forestry/Fishing Mining/Extractive Property Services Business Services Transport/Storage Communications Wholesale/Retail Trade E-Business/E-Commerce Recruitment

Travel and Tourism Advertising/Marketing

Manuacturing Association/Membership Organisation Construction Film/TV/Radio Libraries, Museums and the Arts Sport/Entertainment/Recreation Education

Electricity/Gas/Water

3. Primary job unction

Accounting Administration Inormation Management/Technology Insolvency and Reconstruction Law Management Accounting Marketing/Sales Financial Planning Superannuation Taxation Auditor External Treasury

International Trade Auditor Internal Human Resources/Training General Management Procurement E-Business/E-Commerce Business Development Financial Management Risk Management Business Advisory Services/

Management Consulting Company Secretarial Corporate Governance

External Reporting Financial Control

4. Job responsibility

CEO/Managing Director Partner in Non-Accounting Business Sel Employed Team Leader/Supervisor Academic/Teacher Chie Financial Oicer or equivalent

Financial Controller General Manager Manager Employee Public Practice Sole Practitioner Public Practice Partner/Director

5. Employer size

1 5 101 200 6 10 201 300 11 20 301 500 21 50 501 1000 51 100 1000+

6. Your communication preerence

ongoing

EmailMail

7. Notice o AGM

EmailMail

8. Membership renewal

EmailMail

9. CPA Australia Annual report

Full Annual Report

Concise Version No Annual Report

Tick all relevant boxes in the ollowing

13. Licences/certiicates

Auditor o Superannuation Funds Australian Financial Services Licence Licensed Insurance Agent (Singapore) Licensed Investment Advisor Registered Company Liquidator Legal Practitioner ICAA Practice Certiicate Licensed Securities Dealer Registered Company Auditor Registered Tax Agent Trustee in Bankruptcy

14. Other memberships you hold

Australia

Australian Computer Society Australian Institute o Management Financial Planning Association Institute o Internal Auditors Australia National Tax and Accountants

Association

Australian Institute o Company Directors Chartered Secretaries Australia Institute o Chartered Accountants

Australia

National Institute o Accountants Financial Services o Australasia

Outside Australia

American Institute o Certiied PublicAccountants

Association o International Accountants Chinese Institute o Certiied Public

Accountants Institute o Certiied PublicAccountants o Singapore

Association o Chartered CertiiedAccountants

Chartered Institute o ManagementAccountants

Hong Kong Institute o CertiiedPublic Accountants

Malaysian Institute o Accountants New Zealand Institute o Chartered

Accountants

15. Proessional interests

Inormation Management/Technology Insolvency and Reconstruction Law Management Accounting

Marketing/Sales Financial Planning Small Business Superannuation Taxation Auditing External Treasury General Management

E-Business/E-Commerce Human Resources/Training/Industrial

Relations Securities/Funds Management Public Sector Issues Risk Management Banking Auditing Internal Financial Markets Insurance TBL/Sustainability Advisory Service/Management

Consulting Company Secretarial Corporate Governance Ethics External Reporting Financial Control


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(C) Provide us with your education history

This section asks you about any studying you have done to help us decide the components o CPA Program that you would need to

complete to qualiy or ull CPA status.

Do you have any relevant qualifcations?

! Have you had your qualiications previously

assessed by CPA Australia?!

Do you have more than two relevant qualiications?

I you had a CPA Australia Qualifcations Assessment or

membership or migration beore, please provide your reerencenumber on page 2 o this orm.

Please add a separate sheet that provides the details or each

additional qualiication.

Qualifcation A

Name o qualifcation

University or Institute

Campus (i applicable)

Country

Full-time study

Part-time study

Have you completed this qualifcation?

Yes I completed it in /

M M Y Y Y Y

No I will complete it in /

M M Y Y Y Y

Please provide a certifed

true copy o ofcial academic

transcripts showing the grades or

results rom the institution where

you completed the original study.

I you have received any exemptions,

credits or advanced standing in

this qualifcation, please include a

certifed true copy o the ofcial

academic transcripts showing the

grades or results rom the institution

where the prior study took place.

I you have completed your

qualifcation, please provide

a certifed true copy o the

ofcial academic award or letter

o completion.

Qualifcation B

Name o qualifcation

University or Institute

Campus (i applicable)

Country

Full-time study

Part-time study

Have you completed this qualifcation?

Yes I completed it in /

M M Y Y Y Y

No I will complete it in /

M M Y Y Y Y

Please provide a certifedtrue copy o ofcial academic

transcripts showing the grades or

results rom the institution where

you completed the original study.

I you have received any exemptions,

credits or advanced standing in

this qualifcation, please include a

certifed true copy o the ofcial

academic transcripts showing the

grades or results rom the institution

where the prior study took place.

I you have completed your

qualifcation, please provide

a certifed true copy o the

ofcial academic award or letter

o completion.

Do you have a relevant proessional membership?

Are you or have you ever been a member o a proessional accounting body?

No

Yes Name o the proessional accounting body

Level o membership

Send us a certifed true copyo your membership certifcateor letter o good standing(i applicable). You should also

send a certifed true copy o yourofcial results or all proessionalpapers or examinations youcompleted with this body.


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(D) How to pay

How much is the application fee?

There is a non-reundable ee to assess your application.

it is charged inAustralian dollars

you can pay this ee by credit card, cheque or bank drat

it is based on your preerred mailing address, as ollows

If your preferred mailing address is in This charge is

Australia AUD$138 (GST inclusive)

New Zealand AUD$144 (NZ GST inclusive)

Hong Kong, Malaysia or Singapore AUD$125

You can pay by cheque, credit card or in person at your local CPA Australia ofce in

your local currency, using a set monthly exchange rate.

see the current application ee rate at cpaaustralia.com.au/memberfees

contact your local ofce listed on cpaaustralia.com.au/contact

Any other location AUD$125

If you are paying by credit card

Select which credit card would you like to use.

AMEX Visa Diners Club MasterCard

Card number

Expiry date

/

M M Y Y

Cardholders name

Total amount

Cardholders signature

Please ensure these numbers are

entered clearly and correctly.

Please print and sign. We do not

accept digital signatures.

If you are paying by cheque

Your cheque should be made payable to CPA Australia Ltd.

Personal cheques will only be accepted i drawn on an Australian bank account unless paying directly to our ofces in Hong Kong, Malaysia

or Singapore. You will be liable or any ees incurred rom a dishonoured cheque.

I you are paying rom outside o Australia, the bank drat must nominate a corresponding Australian bank through which we can process

the payment.

Tick this box i are paying by cheque and staple your cheque to this page.
http://www.cpaaustralia.com.au/memberfeeshttp://www.cpaaustralia.com.au/contacthttp://www.cpaaustralia.com.au/contacthttp://www.cpaaustralia.com.au/memberfees


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(E) Terms and conditions or membership applications

Privacy Statement

As part o your application, you will need to read and agree to this Privacy Statement.

CPA Australia Ltd (CPA Australia) is committed to protecting the privacy and security o your personal inormation.

The personal inormation you provide may be used by CPA Australia to:

process your application or membership with CPA Australia

record your membership details and profle inormation

manage your membership o CPA Australia ensure you comply as a member with CPA Australias Constitution and By-Laws

conduct market research in order to identiy and analyse the ongoing needs o CPA Australia members

provide you with access to and inormation about a range o current and uture membership benefts including Member Benefts+

enrol you in the CPA Program

administer the CPA Program

administer your enrolments

administer your exams

customise uture service oerings, such as exams or the CPA Program

compile an employer-requested list or your employer o those persons in their employment undertaking the CPA Program and their

member status

notiy you about CPA Australia events

arrange study group contact i required aggregate and use or internal review to analyse trends and statistics

Failure to complete the application orm correctly may delay or render us unable to process your application.

CPA Australia may disclose the personal inormation you provide to:

CPA Program providers

Member Benefts+ partners so that they may contact you about their products and services. For a ull list o Member Benefts+ partners,

see the CPA Australia website cpaaustralia.com.au

external service providers to whom we have contracted out unctions such as printers, mailing houses, IT companies and marketing

and communications agencies

universities and other education providers, proessional and regulatory bodies, governmental departments such as the Department

o Immigration and Citizenship, Australian Education International - National Ofce o Overseas Skills Recognition and Department o

Education, Employment and Workplace Relations

The personal inormation you provide will be treated by us in the ollowing ways:

your personal inormation may be transerred or stored outside the country where the inormation was collected or the purposes stated above

you have the right to access personal or correct any personal inormation which CPA Australia holds about you, (subject to any

applicable legal exceptions) and can do this via the 'Update my profle' service on the website at cpaaustralia.com.au . You can use

this service to opt out o receiving urther communications rom CPA Australia. For more inormation on CPA Australia's Privacy Policy,

visit the CPA Australia website

CPA Australia processes assessment payments using EFTPOS and online technologies. All transactions processed by CPA Australia meet

industry security standards to ensure member details and payments are protected. For more inormation about our security procedures and

payment processes contact +61 3 9606 9606.

Your acceptance

I wish to apply or an assessment by CPA Australia.

I have read and agree to the Privacy Statement.

Your signature

Date / /

D D M M Y Y Y Y

I you do not want to receive inormation about our Member Benefts+ partners and their

products and services, please tick this box.

Please print and sign. We do not

accept digital signatures.

Please turn the page to

fnd out what to send us

and where.
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What to send

Please send us your: application orm (pages 2 to 9) payment details or application ee supporting documents (see below)

Attach your supporting documents

You will need to send us certifed true copies o some o the ollowing documents.

We suggest that you tick each row in the checklist below when you have collected the documents to send to us.

3 I Please send us certifed true copies o

You wish us to process your application. Your identity documents (see page 5).

Your name is dierent on any o your transcripts

or identity documents

Your proo o change o name documentation such as:

a marriage certifcate or government-issued change o name documents

You have previously had a CPA Australia QualifcationsAssessment or membership or migration

Your assessment letter, i you have this.

You have completed or are completing arelevant qualifcation

Your ofcial academic transcripts or exam results.

I you have received any exemptions, credits or advanced

standing in this qualifcation, please include a certifed true

copy o the ofcial academic transcripts showing the grades

or results rom the institution where the prior study took place.

I you have completed your qualifcation, please provide

a certifed true copy o the ofcial academic award or letter

o completion.

You are a qualifed member o a recognised InternationalFederation o Accountants (IFAC) proessional body

Your membership certifcate or letter o good standing(i applicable). You should also send the ofcial results orall proessional papers or examinations you completed withthis body.

! Please note

Please do not staple this orm or any documents together. However, you can:

use a paper clip to hold your pages together

staple any cheques or money orders or the application ee to page 8

Please do not attach any sticky notes to your application.

You need to send us certifed copies o your supporting documents

When you send us copies o your documents, they must be certifed true copies o the originals and in English. You will need to have

non-English documents ofcially translated. Send us a certifed true copy o the original language document and a certifed true copy o

the translation.

Do not send original documents. They will not be returned.

What is a certifed true copy" o an original?

A certifed copy is a copy o an original document that is verifed as being a true copy. An authorised person must certiy the copy ater

seeing the original document. A list o authorised people who can certiy documents is below.

What needs to be certifed?

copies o all identity documents

documents relating to your education (e.g. academic transcripts, academic award or letter o completion)

documents relating to proessional memberships

non-English documents, as listed above, and the corresponding English version that have been translated by a proessional translator


What to send us


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How do I get my documents certifed?

1. photocopy your original documents

2. take your original documents and photocopies to a person who is authorised to certiy documents

3. have the authorised person certiying

write on each copy I certiy this is a true copy o the original document sighted by me

sign and print their name

state their proession or occupation group (as below)

member number (i applicable)

the date certifed (within the last 12 months)

We do not accept

photocopies or axes o certifed documents

certifcations where the identity o the person certiying cannot be read

certifcation made by a person not authorised to certiy documents certifcation made by yoursel, on your own documents, even i you are a person authorised to certiy documents

Who can certiy my documents?

The ollowing people are authorised to certiy documents:

sta at your local CPA Australia ofce listed on the CPA Australia website cpaaustralia.com.au/contact

CPA or FCPA (Fellow) but this person cannot be an Associate member o CPA Australia

ull member o a recognised International Federation o Accountants (IFAC) proessional body as listed on

www.iac.org/about/member-bodies

commissioner or oaths

Justice o the Peace

solicitor or lawyer

migrant agent registered with Migration Agents Registration Authority (MARA)

dentist, medical practitioner, pharmacist or veterinary surgeon

bank manager, school principal or registered migration agent

police ofcer, sheri or sheris ofcer

notary ofcer

Australian consular or diplomatic ofcer

any other ofcial, who in your home country, is authorised to endorse documents and legal declarations or to witness sworn afdavits

Statement by personauthorised to certiy

Member numberPrinted name

Signed name

Statement o proession

Date the original documentwas sighted and the copy wascertifed
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Where to send your application

Your application and documents can be:

mailed to one o the addresses below, or

brought to your local CPA Australia oce listed on the CPA Australia website at cpaaustralia.com.au/contact

They cannot be axed or emailed.

Your location Mail your application to

Australia & all other

locations

CPA Australia

Member Advisory and Inormation ServicesGPO Box 2820

Melbourne VIC 3001

AUSTRALIA

Telephone: 1300 73 73 73 (in Australia) or + 61 3 9606 9677 (outside Australia)

Greater China CPA Australia

20/F Tai Yau Building

181 Johnston Road

Wanchai

HONG KONG

Telephone: +852 2891 3312

Malaysia CPA Australia

Suite 10.01, Level 10

The Gardens South Tower

Mid Valley City

Lingkaran Syed Putra

59200 Kuala Lumpur

MALAYSIA

Telephone: +603 2267 3388

Singapore CPA Australia

31 01 One Rafes Place

1 Rafes Place

SINGAPORE 048616

Telephone: +65 6671 6500

What happens next?

1. We will send you an acknowledgement email

Our email will let you know:

we have received your application

how to track the progress o your application or contact us with any questions

2. We will let you know i your application cannot be processed

This may occur i:

your orm is incomplete or unsigned

certifed true copies o relevant documents have not been provided

3. We will let you know the outcome o your applicationThis assessment will help to determine your starting point in CPA Program and your eligibility or membership.

In general, you should receive our response by email within 10 working days. You can nd our current response times at

cpaaustralia.com.au/apply.Please check that you have provided the correct clearly written email address to contact you.
http://www.cpaaustralia.com.au/contacthttp://www.cpaaustralia.com.au/applyhttp://www.cpaaustralia.com.au/applyhttp://www.cpaaustralia.com.au/contact


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13CPA A t li M b hi A t A li ti (2011)

Enrolment dates or the 2012 CPA Program proessional level

Semester 1 Semester 2

Enrolments openFriday 9 December 2011

6.00pm AEDST

Friday 15 June 2012

6.00pm AEST

Early bird enrolment ee closing date

(Proessional level only)Monday 16 January 2012 Monday 9 July 2012

Enrolments close(Proessional level only)

Monday 30 January 2012 Monday 23 July 2012

Semester begins Monday 13 February 2012 Monday 6 August 2012

Enrolments for the CPA Program are not accepted if received after the enrolment closing date.

Important inormation

you have six years (12 semesters) to complete the CPA Program proessional level

i you have not completed a recognised Taxation and a recognised Auditing unit at university, you must enrol in Advanced Taxation and

Advanced Audit and Assurance in the CPA Program proessional level or your two electives

I you need help or more inormation

You will fnd more inormation about the CPA Program at cpaaustralia.com.au/cpaprogram

http://www.cpaaustralia.com.au/cps/rde/xchg/cpa-site/hs.xsl/pd-cpa-program.htmlhttp://www.cpaaustralia.com.au/cps/rde/xchg/cpa-site/hs.xsl/about-contact-us.htmlhttp://www.cpaaustralia.com.au/cps/rde/xchg/cpa-site/hs.xsl/about-contact-us.htmlhttp://www.cpaaustralia.com.au/cps/rde/xchg/cpa-site/hs.xsl/pd-cpa-program.html

Documents

Membership Entry Pathways Assessment Form