CPA AUSTRALIA ENROLMENT FORM FOR MUTUAL RECOGNITION AGREEMENTS PLEASE READ THESE INSTRUCTIONS CAREFULLY You can enter your details directly into the enrolment form on your computer and then send us a printed and signed copy. We recommend that you keep a copy for your own records. Incomplete forms cannot be processed and this will delay your enrolment. WHAT IS THIS FORM FOR? Once you have completed a Membership Application for Mutual Recognition Agreements, you can use this form to enrol in your remaining study units to attain the CPA designation. If you have not applied for membership, you will need to send us an application form. Information is available on the CPA Australia website at cpaaustralia.com.au/internationalaffiliations (A) ABOUT YOU YOUR PERSONAL DETAILS CPA Australia ID / Member number Title Last name Gender First name This will be used as your first name in our correspondence. Preferred name (optional) Date of birth Your email address (mandatory) Email YOUR ADDRESS DETAILS Your home address details with CPA Australia will be updated based on the information you provide on this form. Home address Suburb or city State, Province or Region Postcode or ZIP Country YOUR MAILING ADDRESS Your mailing details with CPA Australia will be updated based on the information you provide on this form. Mailing address Your study materials, if applicable, will be sent to this mailing address. A street address is recommended. Suburb or city State, Province or Region Country Postcode or ZIP In Australia: Study materials are mailed to street addresses and post office boxes. Outside Australia: Study materials are couriered to street addresses. If you live in Russia, your study materials must be sent to a business address. Ensure you include the business name. 2 | Membership application and CPA Program professional level enrolment form (B) ENROL Important semester dates Semester 1 Semester 2 Enrolments open Monday 9 December 2013 Monday 16 June 2014 Early bird study unit fee closing date Tuesday 14 January 2014 Tuesday 15 July 2014 Enrolments close Tuesday 28 January 2014 Monday 28 July 2014 Semester begins Monday 10 February 2014 Monday 4 August 2014 Important online dates Enrolments are open all year SELECT YOUR STUDY UNIT Your professional body Study Unit Semester 1 Semester 2 Online CGA Canada members CPD063 Better Practice in Governance and Accountability N/A N/A CMA Canada members CPA101 Advanced Audit and Assurance N/A CPA Ireland members CPA118 Ethics & Governance N/A CPA117 Global Strategy & Leadership ICAI members N/A CPD063 Better Practice in Governance and Accountability ICASL members N/A N/A CPA118 Ethics & Governance SELECT YOUR EXAM LOCATION For semester based study, once you have received your enrolment confirmation email, please go to cpaaustralia.com.au/mycpaprogram to schedule your exam venue, time and date. (C) YOUR AGREEMENT I agree to be enrolled in the mutual recognition agreement study units. I understand that CPA Australia has the right to vary or cancel an enrolment made on the basis of incorrect or incomplete information. I have read, understood and agree to be bound by the study unit rules and regulations available at the following links: CGA Canada: cpaaustralia.com.au/cgacanadarules CMA Canada: cpaaustralia.com.au/cmacanadarules CPA Ireland: cpaaustralia.com.au/cpairelandrules ICAI: cpaaustralia.com.au/icairules ICASL: cpaaustralia.com.au/icaslrules I have read the Privacy Policy at cpaaustralia.com.au/privacypolicy and consent to my personal information being collected, held, used and disclosed in the manner and for the purposes stated there. Signature Date Your location Mail your form to Australia & all other locations CPA Australia Member Administration GPO Box 2820 Melbourne VIC 3001 AUSTRALIA / OR / Courier your form to CPA Australia Member Administration Level 20, 28 Freshwater Place Southbank VIC 3006 AUSTRALIA 3 | Membership application and CPA Program professional level enrolment form WHAT HAPPENS NEXT? 1. We will send you an enrolment confirmation email. 2. If you enrol into a semester segment, we will mail you study materials. You will also have access to My Online Learning, CPA Australia's online learning platform. 3. If you enrol into an online study unit, we will email you instructions on how to access the online study unit. You will have six months to complete the online assessment through My Online Learning, CPA Australia's online learning platform. (D) HOW TO PAY You can pay these fees by credit card, cheque or bank draft. Semester 1 fees Closing Date If your home address is in Australia Tuesday 14 January 2014 AUD$900 Semester 1 If your home address is in Australia Tuesday 28 January 2014 AUD$1000 Closing Date If your home address is in Australia Early Bird Fee Tuesday 15 July 2014 AUD$900 Semester 2 If your home address is in Australia Standard Fee Monday 28 July 2014 AUD$1000 Product CPA101 Advanced Audit and Assurance CPA118 Ethics & Governance CPA117 Global Strategy & Leadership Early Bird Fee Standard Fee Semester 2 fees Product CPA101 Advanced Audit and Assurance CPA118 Ethics & Governance CPA117 Global Strategy & Leadership Online fees Product Australia CPD063 Better Practice in Governance and Accountability AUD$197 (GST inclusive) If your home address is in Hong Kong, New Zealand, Malaysia, Singapore or the United Kingdom – local currency equivalents apply. To find your applicable fee in your local currency, please go to: cpaaustralia.com.au/fees* If your home address is in any other location, fees are to be paid in Australian dollars (exclusive of GST). To find your applicable fee, please go to cpaaustralia.com.au/ fees* *all prices are subject to change. 4 | Membership application and CPA Program professional level enrolment form IF YOU ARE PAYING BY CREDIT CARD Card Type CPA Australia American Express AMEX Visa MasterCard Diners Name on card Total amount Card number Expiry date / I authorise CPA Australia to debit my credit card for this total amount. Cardholder's signature Date / / Please ensure card 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 if drawn from an Australian bank account unless paying directly to our offices in Hong Kong, Malaysia, Singapore or the United Kingdom. You will be liable for any fees incurred from a dishonoured cheque. If you are paying from outside of Australia, the bank draft must nominate a corresponding Australian bank through which we can process the payment. CPAH0977_B_05/2014 Tick this box if you are paying by cheque and staple your cheque to this page /