POST-GRADUATE CERTIFICATE IN THE THEORY OF ACCOUNTING (CTA) APPLICATION FORM 2016

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POST-GRADUATE CERTIFICATE IN THE THEORY OF ACCOUNTING (CTA) APPLICATION FORM 2016 BEFORE YOU START COMPLETING THEIS FORM PLEASE READ AND SIGN THE FOLLOWING CONSENT TO COLLECT PERSONAL INFORMATION. I accept, agree and understand that CAA must collect and process my personal information for academic, administrative and support services. I hereby consent to the processing of my personal information for this purpose. Signature of applicant INSTRUCTIONS FOR COMPLETING THE APPLICATION Please read the instructions carefully and complete all sections Incomplete forms will not be processed. Only ONE application form per program. Ensure that you meet the entry requirements for the program you are applying for. Detailed requirements are available on our website: http:// Application forms can be sent to admin@caazim.org or can be delivered at CAA at 2 nd Strachans House floor 66 Nelson Mandela, Harare. Please allow 2 weeks from application closure date before checking on the status of your application. Emails will be sent to all successful candidates. You can also check for status of your application on ADMISSION REQUIREMENTS All application forms should be completed by 30 November 2015. All late submission will attract a late application fee. Application fee of $20 is required for your application to be processed. Pay on submission or send proof of payment together with your application documents. Payments can be made through our Bank. Bank CABS Branch Platinum Account Name Safe Service Pvt Ltd Account Number 9016449476

SECTION A :PERSONAL DETAILS Indicate program applied for: CTA Full-time CTA Part-time (Part1) First Name Middle Name Surname Have you been registered at CAA before (Please tick) Yes No If YES, please enter student registration Number Nationality Country of Permanent Residence National ID # Passport Number Date of Birth (dd-mm-yyyy) Gender (tick) Male Female Marital Status Married Single Divorced Permanent Address Mailing Address Postal Code Telephone Number Fax# Email Address

Do you have any disability If yes(please tick) Visually impaired Motor impaired Hearing impaired Speech impaired Do you suffer from chronic illness? (Please tick) Yes No If Yes, please specify: Do you use a wheelchair? (Please tick) Yes No If Yes, please specify: SECTION B Note: Fill in the names of schools, must submit certified copies of certificates/transcripts to prove the stated Qualification O Level or Equivalent :EDUCATION BACKGROUND School Name School Address From To Examination Authority( e.g. ZIMSEC) Subject Grade Subject Grade 1. 7. 2. 8. 3. 9. 4. 10. 5. 11. 6. 12. A Level or Equivalent School Name School Address From To Examination Authority( e.g. ZIMSEC) 1. 2. 3. 4. 5. Subject Grade

SECTION C :HIGHER EDUCATION List all periods of registration at other Universities and Colleges. Please enclose certified copies of your certificates/ results statements From Year Tertiary Institution Qualification Obtained To SECTION D Name of Employer/Organisation Address of Employer/Organisation :WORK EXPERIENCE (List any full time or voluntary work you have engaged in) From Year Job Title Responsibility To SECTION E :FINANCES How do you intend to finance your studies at CAA (Please tick below) Self Family Employer Scholarship Name of sponsor (if not self) Address of sponsor Sponsor s telephone number Sponsor s email address

SECTION F Once you have completed this application form, please read the following statements carefully. By signing this application form you confirm your acceptance of these statements. If you do not sign this form, we cannot process your application. I confirm that the information I have provided on this application form is (to the best of my knowledge) true, accurate, current and complete; and I agree to notify the Academy promptly if any information contained on this application form should change, in order to keep true, accurate and complete. PLEASE NOTE: All admissions decisions taken by the Academy rely on the statements made on the application form and in the supporting materials supplied by you and your referees. This information will be held and used for the purpose of processing your application for study, for student admission and, where relevant, for funding purposes. If the academy believes that any information or statement contained on your application form may not be true, accurate, current and complete, or that any material submitted in support of your application may not be entirely your own original work, except where clearly stated otherwise, it may take necessary steps to verify that information or statement, or to confirm that any supporting material is entirely your own original work, except where clearly stated otherwise. If the academy believes that any information or statement contained on your application form may not be true, accurate, current and complete, or that any material submitted in support of your application may not be entirely your own original work, except where clearly stated otherwise, the academy retains the right to reject your application. If you have been made an offer by the academy, then may in these circumstances withdraw or amend that offer. If you have been admitted as a student, that status may be withdrawn. DECLARATION I consent to the collection, processing, sharing and use of relevant personal data by the academy for the purpose of processing my application for study, for student admission and (where applicable) for funding purposes. I understand that such personal data may be used and shared with third parties, for the purposes of verifying my identity, qualification, work experience, references and submitted work.

I understand that the Academy will normally only discuss my application with me, unless I have specified otherwise. I understand that if any information or statement provided on or to support this application form is not true, accurate, correct or complete, the academy may process and use this fact as relavant personal data. Such data may be used and shared with third parties, including Higher Education Institutions as well as the Institute of Chartered Accountants Zimbabwe, to the extent necessary for the purpose of preventing fraudulent or dishonest applications from studying. I understand that if I become a registered recognized student, and personal data collected by the Academy as a result of my application will form part of my student record. Please sign below to confirm acceptance of these statements: SIGNATURE: DATE: SIGNED (PLEASE PRINT NAME): CHECK LIST Yes/No Have you completed pages 1-5 of this form? Have you signed this form? Check pages 5 Have you enclosed an appropriate application fee? Have you filled in your correct personal details? Have you enclosed certified copies of the following? Birth Certificate ID O Level Certificate A Level Certificate Degree Certificate Degree Transcript

Return the completed forms and documentation to the administrator at: Chartered Accountants Academy Second Floor Strachan s House 66 Nelson Mandela Avenue Harare OR Email scanned copies to admin@caazim.org For any enquiries contact us at: 008844146073 08644121786 Email: admin@caazim.org