Enrolment for Professional Ethics (PETH) Course

Transcription

1 Enrolment for Professional Ethics (PETH) Course Indicate which provisional membership pathway is applicable to you: Provisional Associate Chartered Accountants Provisional Accounting Technicians Please fill in your Membership Number, if known (please use a BLACK pen). Please complete ALL the sections (1 7) below, and return the application with payment to Chartered Accountants Australia and New Zealand (CA ANZ). (See page 4 for contact details). Please print in BLOCK LETTERS. To enrol in the Professional Ethics Course you will need: Regular access to the internet Good English language skills. If English is not your first language an IELTS 5.5 or equivalent is required. You must be a provisional member of Chartered Accountants Australia and New Zealand, and be able to sit the assessments at Auldhouse exam venues in New Zealand. Once your application for enrolment has been assessed (up to 4 weeks) you will be notified in writing. Section 1 Personal details Title Mr Mrs Ms Miss other Date of birth DD / MM / YY First name/surname Preferred first name (if different to formal) Previous name (if applicable) Gender (please tick) Male Female Current employer Section 2 Contact details 1. Residential contact details Street address Suburb/City State Postcode Country (preferred) (alternative) Phone (home) Phone (business) Mobile 2. Mailing contact details (if different to above) Company name (if applicable) Position title Street address Suburb/City State Postcode Country

2 Enrolment for professional ethics (PETH) course 2 Section 3 Studying PETH Please tick to confirm that you would like to enrol in: Professional Ethics only (up to six months tuition) For Provisional members to meet their professional competence requirements Please indicate your preferred exam location (please tick) Auckland Wellington Christchurch Learning Difficulties/Disabilities Information concerning any disability, competency, learning difficulty or medical condition that may affect your learning or ability to sit exams must be outlined in this form, so we can understand your needs and any special requirements. Is there any information you would like recorded? yes no If yes please provide details Section 4 Fees Please complete the relevant fees table below to identify the amount payable Professional Ethics only (six months tuition) $ Includes GST total of $36.00 Fee overseas $ Excluding GST Total payable All fees include online tuition fees through Home Learning College and Chartered Accountants Australia and New Zealand programme management fees. Fees relating to services provided by UK provider and Home Learning College do not incur GST. Please note that exam fees are additional, payable prior to sitting the examination. Refer to information notes on fees. Pay by Credit card Amex Diners Mastercard Visa Card holder s name Any variation to the total amount due please explain? Card number Expiry date: / Card holder s signature: Cancellation Policy: Enrolment cancellation requests while a provisional member of Chartered Accountants Australia and New Zealand training with Home Learning College, must be received in writing to Chartered Accountants Australia and New Zealand up to the end of the seventh day after you have received the course. Refer to Home Learning College s Terms and Conditions that will be ed to you as part of the enrolment process. Please note that subject to your statutory rights, no refunds are payable in relation to cancellation requests received more than seven days after the course has been received.

3 Enrolment for professional ethics (PETH) course 3 Section 5 Privacy statement Privacy Statement IMPORTANT: Your consent to disclosure By providing personal information to us in this form you consent to CA ANZ: (a) Disclosing to third parties your (current or former) status as a member or candidate of CA ANZ; (b) Disclosing to regulators, law enforcement bodies, professional associations and government or statutory bodies the details of any final adverse determinations (including sanctions) in relation to your professional and/or ethical conduct that are made by CA ANZ s Professional Conduct bodies; and (c) Collecting from third parties information relating to your membership of a trade or professional association or union, your criminal record (if any), your health, religious beliefs or affiliations, racial or ethnic origin and any other sensitive information to the extent that it is reasonably necessary for one more of the functions or activities of CA ANZ. We collect, use and disclose your personal information in connection with your application, the management and administration of members and/or programs, the provision of products and services and/or to communicate with you. If you do not provide your personal information, we may be unable to process your application. We may disclose your information to agents, contractors and service providers such as where we outsource functions and to other third parties such as local and international professional bodies, ASIC and other regulators and government bodies. By completing this form, unless you opt-out, you consent to us also using and disclosing your information for promotional and marketing purposes. You can opt-out by contacting us at [email protected]. We may also have collected information about you from a third party, for instance from other professional bodies with which we have reciprocal arrangements. Your information will also be used and disclosed as set out in CA ANZ s Privacy Policy, available at It is likely that your personal information will be disclosed to overseas recipients (as provided in our Privacy Policy, including the location of those entities). The Privacy Policy sets out how CA ANZ handles your personal information including how you can seek to access and correct your information or raise a privacy concern with us and how it will be dealt with as well as details about the disclosure of your information to entities overseas. Chartered Accountants Australia and New Zealand. Formed in Australia. Members are not liable for the debts and liabilities of Chartered Accountants Australia and New Zealand. ABN Section 6 Declaration (refer to guide at the back of this form) The declaration has been updated and replaces the declaration you made when applying for provisional membership. I declare that: 1. The information provided in this application is true and correct and agree to produce such further evidence and information in relation to this application as may be required. 2. I have read and agree to be bound by Chartered Accountants Australia and New Zealand Royal Charter, By-Laws, Regulations, and any other policies or guidelines prescribing any ruling, on-line standards or practice and professional conduct including the technical standards as required by Chartered Accountants Australia and New Zealand and the Rules and Code of Ethics of the New Zealand Institute of Chartered Accountants now in force or hereafter voted into existence or amended from time to time. 3. I agree to abide by the lawful decisions of the Chartered Accountants Australia and New Zealand Board or any Regional or Local Council, Standing or other Committees or Officer of Chartered Accountants Australia and New Zealand, and by the lawful decisions of the New Zealand Regulatory Board and any permanent body of NZICA. 4. I authorise Chartered Accountants Australia and New Zealand and the New Zealand Institute of Chartered Accountants to lawfully obtain at any time, from any person or entity, any information about me that either of them considers necessary or desirable to obtain in order to process this application and to service and maintain my membership, and I authorise any such person or entity to release this information to Chartered Accountants Australia and New Zealand or the New Zealand Institute of Chartered Accountants (as applicable). 5. I have read, understand and agree to all of CA ANZ s terms and conditions and consent to CA ANZ s privacy policy and statement, available at 6. I acknowledge that the information provided is made with the due care and consideration of my obligations as a member of CA ANZ to uphold the principles of integrity, ethical practice, due care and professional behavior. 7. Copies of documentation submitted by me are a copy of the original documentation and that I will submit the original document to CA ANZ if required. Please sign and date Signature Date / /

4 Enrolment for professional ethics (PETH) course 4 Section 7 Checklist Have you: completed the application form in full attached the signed declaration completed the payment details Section 8 Submitting your application form HOW TO SUBMIT YOUR FORM Please your application form to: [email protected] OR If you have a digital signature simply click the submit button ANY QUESTIONS If you have any questions you can contact the Service Centre at: [email protected] Phone AUSTRALIA (outside of Australia) 8am-6pm (AEST) Monday Friday (excl. Public Holidays) NEW ZEALAND (outside of New Zealand) 8am-6pm (NZ time) Monday Friday (excl. Public Holidays) Website charteredaccountantsanz.com

5 Enrolment for professional ethics (PETH) course 5 Enrolment for professional ethics (PETH) course Guide to the form HOME LEARNING COLLEGE Home Learning College is a UK company that provides online tuition for our provisional members via an online campus. Please note that Home Learning College is not related to Chartered Accountants Australia and New Zealand, and Chartered Accountants Australia and New Zealand is not responsible for the services they provide. Part of your application process includes signing up to Home Learning College s terms and conditions that will be ed to you as part of their enrolment process. Withdrawing from the programme In the event that you choose to withdraw from the PETH programme, or suspend your participation for any reason, you will still be entitled to remain a provisional member of Chartered Accountants Australia and New Zealand, subject to you complying with your on-going obligations as a provisional member. Fees Fees are payable to Chartered Accountants Australia and New Zealand at first instance. On receipt of your fee, Chartered Accountants Australia and New Zealand assumes responsibility for passing on the relevant component of your fee to Home Learning College. In consideration of that fee payment, Chartered Accountants Australia and New Zealand takes on the obligation to facilitiate your access to the services provided by those two entities on the basis advertised, but does not take on any responsibility for the services they provide. DECLARATION The information you give in this application form is covered by this declaration. Chartered Accountants Australia and New Zealand regulates the conduct its members of (except to the extent that certain members are residents of New Zealand) in accordance with the Supplemental Royal Charter, By-Laws and Regulations. Such members must comply with the Royal Charter, By-Laws, Regulations, Codes and other policies and guidelines applicable. NZICA regulates the conduct of members of Chartered Accountants Australia and New Zealand that reside in New Zealand in accordance with the NZICA Act and Rules and other legislation regulating the profession of accountancy in New Zealand. This function is overseen by the New Zealand Regulatory Board. Members resident in New Zealand must comply with NZICA s Rules and Code of Ethics and all other professional and technical standards applicable. To the extent that members give authority to Chartered Accountants Australia and New Zealand to lawfully obtain any information about them under section (5)(3), this authority also extends to NZICA for the purpose of carrying out its regulatory function. OFFICE USE ONLY Prov member Unit match Declaration completed HLC information collected