2016 CIA Examination Application Form For Australian Candidates only Personal Details Membership ID First Name Last Name Name as it appears on Photo ID Home Address Position Organisation Date of Birth Phone/Mobile Email Internal Auditor Experience None Less than 1 Year 1-2 Years Over 2 Years Fees & Charges Australian CIA Application Fee $175 CIA Part I $350 CIA Part II $300 CIA Part III $300 CIA Package excluding application fee $850 (Part I + Part II + Part III). Taking this package does not mean you have to sit all 3 exams at the same time. This package does not incude CIA Application fee. Other Fees and Charges Master Card & Visa Surcharge %1.5 AMEX & DINERS Surcharge %3 Disability Tick here if you need accommodation during the examinations for a disability. Include a separate letter stating what type of accommodations you require. Terms & Conditions 1. you must be a member of IIA- Australia in order to register for Examination. 2. All fees are correct at the time of printing and are subject to change. 3. Candidates must take their exam within 6 months (180 days) of their exam registration date. If a candidate fails to sit for their exam within 6 months (180 days) timeframe, the fee paid for the
exam part will be forfeited 4. Exam Fees are non refundable for all candidates including candidates who do not achieve a pass grade on their exams 5. The certification program eligibility requires candidates to complete the program certification process within four years. If this time frame is not met, all fees and exam parts will be forfeited 6. By signing this form I accept the above terms and conditions and I certify that I have read and will abide by the IIA Codes of Ethics. Date Signature Check List I am a member of IIA Australia Character Reference Form Attached equivalent Qualification copy of driving license or passport How did you find out about this certification IIA- Australia website Google LinkedIn Other: please specify I wish to become a member of IIA-Australia Experience Verification Form Attached copy of degree other (if applicable) IIA-Australia Emails Colleague/Peer Magazine Payment Details Cheque AMEX MASTERCARDS VISA DINERS CLUB Money order Card Number: ---- ---- ---- ----/---- ---- ---- ----/---- ---- ---- ----/---- ---- ---- ---- Expiry Date: ---- ----/---- ---- Amount: $------ Cardholders name (Please print): Direct Deposit Westpac Banking Corporation BSB: 032 003 Account No: 478233, King Street, Sydney NSW 2000 Return to ABN 80 001 797 557 Cheques payable / Posted to : Institute of Internal Auditors Australia PO Box A2311, Sydney South NSW 1235 t +61 (0) 29267 9155 f +61 (0) 29264 9240 e certification@iia.org.au 2 P a g e
Character Reference Form Note to Recommender The individual named below has applied to one of the certification programs administered by The Institute of Internal Auditors. In considering the candidate s qualifications for any of our certifications, we require a character reference evaluation by an individual with an IIA certification, the candidate s supervisor, or the candidate s professor. The basis for this evaluation is the Code of Ethics established by The IIA. Please read the Code of Ethics and then complete and sign this form. The Code of Ethics is available at www.globaliia.org/standards-guidance. Information about Candidate Title(Prof/Dr/Mr/Mrs/Ms/Miss) First Name: Family Name: Organisation: Information about Recommender I am (please check all that apply): A CIA (Certified Internal Auditor) A CCSA (Certification in Control Self- Assessment) A CFSA (Certified Financial Services Auditor) The Candidate s supervisor (current or prior) A CGAP (Certified Government Auditing Professional) A CRMA (Certification in Risk Management Assurance) The Candidate s Professor Other : please specify Recommender s details Title(Prof/Dr/Mr/Mrs/Ms/Miss) First Name Family Name Address Phone/Mobile: Organisation: Email: Statement of Character Reference In my opinion, (Candidate s name) Meets the qualifications set forth by the Code of Ethics established by The Institute of Internal Auditors. Recommender s signature: Date: 3 P a g e
Internal Audit Experience Verification Form This form or a photocopy of this form should be used to verify attainment of 24 months of internal auditing or equivalent experience (that is, experience in audit/assessment disciplines such as external auditing, quality assurance, compliance or internal control) by the candidate. The following candidate information should be completed and verified by a CIA or a CFSA or a CCSA or a CGAP or by candidates supervisor or the candidate s professor/lecturer. Candidate s Personal Details: Title(Prof/Dr/Mr/Mrs/Ms/Miss) First Name: Family Name: Organisation: The individual named above has applied to the following certification program (check one) and must submit a completed, verified copy of this form in order to complete t he experience requirement, as outlined below Candidate is applying for :- A CIA (Certified Internal Auditor) 24 months in internal audit experience or its equivalent (defined as experience in audit/assessment disciplines, including external auditing, quality assurance, compliance, and internal control. Please check here if you have submitted a Master s degree A CCSA (Certified in Control Self-Assessment) 12 months of control related business experience such as CSA auditing, quality assurance, risk management, or environmental auditing. A CFSA (Certified Financial Services Auditor) 24 months of audit experience in financial service environment A CGAP (Certified Government Auditing Professional) 24 months of auditing experience in a government environment (federal state/provincial, local quasi-governmental areas, authority/crow corporation A CRMA (Certified Risk Management Auditor) 24 months of auditing experience or controls related business experience such as risk management and quality assurance. Candidate s Experience The following information about the candidate should be listed in chronological order, with the most recent position listed first. Please list the candidate s job title, dates employed and a brief description of the candidate s duties and responsibilities. If teaching Title: Dates: From / / To: / / Description of Duties 4 P a g e
Title: Dates: From / / To: / / Description of Duties Title: Dates: From / / To: / / Description of Duties Information about Verifier I am (check all that apply) Title(Prof/Dr/Mr/Mrs/Ms/Miss) A CIA A CCSA A CGAP A CFSA A CRMA The Candidate s supervisor (current or prior) First Name Family Name Address Phone/Mobile: Organisation: Email: Statement of Verification: In verify that, (Candidate s name) has completed at least 24 months of internal auditing or equivalent experience, as described below. Verifier s signature: Date: 5 P a g e
Code of Ethics Introduction The purpose of The Institute's Code of Ethics is to promote an ethical culture in the profession of internal auditing. A code of ethics is necessary and appropriate for the profession of internal auditing, as it is founded on the trust placed in its objective assurance about risk management, control, and governance. The Institute's Code of Ethics extends beyond the Definition of Internal Auditing to include two essential components: Principles that are relevant to the profession and practice of internal auditing Rules of Conduct that describe behaviour norms expected of internal auditors. These rules are an aid to interpreting the Principles into practical applications and are intended to guide the ethical conduct of internal auditors Applicability and Enforcement This Code of Ethics applies to both individuals and entities that provide internal auditing services. For Institute members and recipients of or candidates for IIA-Australia professional certifications, breaches of the Code of Ethics will be evaluated and administered according to The Institute's bylaws and administrative guidelines. The fact that a specific practice is not mentioned in the Rules of Conduct does not prevent it from being unacceptable or discreditable, and therefore, the member, certification holder, or candidate can be subject to disciplinary action. Principles Internal auditors are expected to apply and uphold the following principles: Integrity The integrity of internal auditors establishes trust and thus provides the basis for reliance on their judgement. Objectivity Internal auditors exhibit the highest level of professional objectivity in gathering, evaluating, and communicating information about the activity or process being examined. Internal auditors make a balanced assessment of all the relevant circumstances and are not unduly influenced by their own interests or by others in forming judgements. Confidentiality Internal auditors respect the value and ownership of information they receive and do not disclose information without appropriate authority unless there is a legal or professional obligation to do so. Competency Internal auditors apply the knowledge, skills, and experience needed in the performance of internal auditing services. 6 P a g e
Rules of Conduct 1. Integrity Internal auditors: 1.1. Shall perform their work with honesty, diligence, and responsibility. 1.2. Shall observe the law and make disclosures expected by the law and the profession. 1.3. Shall not knowingly be a party to any illegal activity, or engage in acts that are discreditable to the profession of internal auditing or to the organisation. 1.4. Shall respect and contribute to the legitimate and ethical objectives of the organisation. 2. Objectivity Internal auditors: 2.1. Shall not participate in any activity or relationship that may impair or be presumed to impair their unbiased assessment. This participation includes those activities or relationships that may be in conflict with the interests of the organisation. 2.2 Shall not accept anything that may impair or be presumed to impair their professional judgement. 2.3 Shall disclose all material facts known to them that, if not disclosed, may distort the reporting of activities under review. 3. Confidentiality Internal auditors: 3.1 Shall be prudent in the use and protection of information acquired in the course of their duties. 3.2 Shall not use information for any personal gain or in any manner that would be contrary to the law or detrimental to the legitimate and ethical objectives of the organisation. 4. Competency Internal auditors: 4.1. Shall engage only in those services for which they have the necessary knowledge, skills, and experience. 4.2 Shall perform internal auditing services in accordance with the International Standards for the Professional Practice of Internal Auditing. 4.3 Shall continually improve their proficiency and the effectiveness and quality of their services. 7 P a g e
Gleim Learning Material Form (for CIA Exams) Hard Copy Book and Online Test Prep (2016 Edition) Personal Details Membership ID First Name(s) Last Name Mailing Address Phone/Mobile Email Fees & Charges Australian Overseas (Fiji, PNG, Solomon Islands and Vanuatu Candidates only) CIA Part I $225 $200 + Postage CIA Part II $225 $200 + Postage CIA Part III $275 $250 + Postage CIA Kit (Part I, II, III) $550 $500 + Postage Total Other Fees and Charges Master Card & Visa Surcharge %1.5 AMEX & DINERS Surcharge %3 Bank Fees for Overseas candidates $20.00 Payment Details Cheque AMEX MASTERCARDS VISA DINERS CLUB MONEY ORDER Card Number: ---- ---- ---- ----/---- ---- ---- ----/---- ---- ---- ----/---- ---- ---- ---- Expiry Date: ---- ----/---- ---- Amount: $------ Cardholders name (Please print): Direct Deposit Westpac Banking Corporation BSB: 032 003 Account No: 478233, King Street, Sydney NSW 2000 Return to ABN 80 001 797 557 Cheques payable / Posted to : Institute of Internal Auditors Australia PO Box A2311, Sydney South NSW 1235 t +61 (0) 2 9267 9155 f +61 (0) 2 9264 9240 e certification@iia.org.au 8 P a g e
IIA CIA Learning Material Order Form (book & test Prep only) Published by Institute of Internal Auditors Global (Headquarters) Personal Details Membership ID First Name(s) Last Name Mailing Address Phone/Mobile Email Fees & Charges Australian Overseas (Fiji, PNG, Solomon Islands and Vanuatu Candidates only) CIA Part I $300 $275 + Postage CIA Part II $300 $275 + Postage CIA Part III $300 $275 + Postage CIA Kit (I-III) $750 $680 + Postage Total Other Fees and Charges Master Card & Visa Surcharge %1.5 AMEX & DINERS Surcharge %3 Bank Fees for Overseas candidates $20.00 Payment Details Cheque AMEX MASTERCARDS VISA DINERS CLUB MONEY ORDER Card Number: ---- ---- ---- ----/---- ---- ---- ----/---- ---- ---- ----/---- ---- ---- ---- Expiry Date: ---- ----/---- ---- Amount: $------ Cardholders name (Please print): Direct Deposit Westpac Banking Corporation BSB: 032 003 Account No: 478233, King Street, Sydney NSW 2000 Return to ABN 80 001 797 557 Cheques payable / Posted to : Institute of Internal Auditors Australia PO Box A2311, Sydney South NSW 1235 t +61 (0) 2 9267 9155 f +61 (0) 2 9264 9240 e certification@iia.org.au 9 P a g e