CMA AUSTRALIAS������ M��������� �

E��� R�����������

T�� I�������� �� C�������� M��������� A����������

Part 1 PERSONAL INFORMATION

Title: (Dr/Mr/Mrs/Ms/Miss/Other) _______________ First Name_______________________________________ Preferred Name _________________________________________

Middle Name(s) ___________________________________________________Last Name(s)____________________ ___________________________________________________________

Date of Birth (dd/mm/yy) ______ /______ / ______ Gender [ ] Male [ ] Female

Part 2 CONTACT DETAILS Mailing Address - This is my [ ] Home [ ] Business

Address Line 1: _________________________________________________________________________________________________________________________________________________

Address Line 2: _________________________________________________________________________________________________________________________________________________

Suburb ______________________________ City _________________________________ State _______________ Postcode ___________________ Country ______________________

Home ________________________________ Mobile: ____________________________ Email ______________________________________________________________________________

Part 3 PRESENT OR MOST RECENT EMPLOYMENT

Employer’s Name __________________________________________________________________________________________ Date of Appointment _____________________________

Employer’s Address _____________________________________________________________________________________________________________________________________________

Post Held/Current Occupation/Situation________________________________________________________________________________________________________________________

Important - You must provide your Curriculum Vitae detailing information of the business experience that you think will be of significance to your application, eg. work in

reporting to management; financial management; information systems; financial modelling; internal auditing; pricing; logistics; cost analysis etc. (These must be detailed in

attached Curriculum Vitae)

S������ M��������� � E��� R�����������

Application for CMA Australia Membership

Please complete this form in BLOCK CAPITAL

LETTERS and send to Institute by post or

scan-email. Do not post any original

documents with this form. The Institute will

retain all materials sent with this form.

Students are required to send appropriate fees

in AUD by Bank Draft, or Credit Card details

with this application.

STUDENT MEMBERSHIP AND UNIT EXAMINATION FEES

Please tick one grade of membership application only

Non Refundable Application Fee (Compulsory) AUD $55

Student Membership Fee (Compulsory) AUD $99

CMA Program Units - Examination Fee AUD $55 per unit

[ ] Strategic Cost Management (AUD $55) Exam date:___________

[ ] Strategic Business Analysis (AUD $55) Exam date:___________

[ ] -OR- Research Assignment (AUD $110)* Due date: ___________

(* Available as an alternative to the above two examinations to only to those

attending a CMA face-to-face program, and who have 10+ years experience)

Stage 4 GMA Students - Examination Fee AUD $55 per unit

[ ] Financial Modeling (AUD $55) Exam date:___________

[ ] Financial Management (AUD $55) Exam date:___________

[ ] Financial Statement Analysis (AUD $55) Exam date:___________

[ ] Managerial Accounting (AUD $55) Exam date:___________

Stage 3 for GMA Students - Examination Fee AUD $55 per unit

[ ] Financial Accounting (AUD $55) Exam date:___________

[ ] Marketing Management (AUD $55) Exam date:___________

[ ] Information Management (AUD $55) Exam date:___________

[ ] Strategic Management (AUD $55) Exam date:___________

Stage 2 for Advance Diploma Students - Examination Fee AUD $55 per unit

[ ] Financial Economics(AUD $55) Exam date:___________

[ ] International Business Law & Governance (AUD $55) Exam date:___________

[ ] Business Analysis & Audit (AUD $55) Exam date:___________

[ ] International Business Taxation (AUD $55) Exam date:___________

Stage 1 for CAT Students - Examination Fee AUD $55 per unit

[ ] Organizational Management (AUD $55) Exam date:___________

[ ] Accounting Principles and Practice (AUD $55) Exam date:___________

[ ] Accounting Control Systems (AUD $55) Exam date:___________

[ ] Financial Information Systems (AUD $55) Exam date:___________

CM

A A

ust

ralia

Stu

den

t an

d E

xam

Reg

istr

ati

on

Fo

rm

1

For Official Purposes Only

(Applicants do not complete)

Received On

_______________________________________________________________

Consideration On:

_______________________________________________________________

Ref No:

_______________________________________________________________

Part 4 UNDERTAKING THE PROGRAM EXAMINATION REGISTRATION

I am undertaking the below CMA Australia program/course

[ ] Certified Management Accounting study

[ ] GMA Conversion program study

[ ] Graduate Management Accounting study

[ ] Registered Business Administrator study

[ ] Registered Cost Accountant study

[ ] Certified Accounting Technician study

at (University or CMA Australia Recognized Provider Institution) ______________________________________________________________________________________________

in (country) ____________________________ during the month of ____________ of ___________ year, and my Student Id is ___________________________________________

Part 5 EDUCATION BACKGROUND (Compulsory)

(Academic and Vocational) Please list University and Post School qualifications either obtained or currently being undertaken that will fulfill the

educational requirements of the Graduate Member Program. These might include degrees, graduate diplomas, and any professional or qualifications)

NOTE:

CMA applicants - all students should have a degree or professional qualification in accounting or an MBA

GMA Conversion (Stage 4) applicants - all students should have a degree or professional Qualification in any field other than accounting

GMA applicants – Satisfactory completion of a High School Certificate (e.g. VCE, GCE, IB, SAT etc.)

Qualifications Institution Year Grade

1 _______________________________________________________________________________________________________________________________________________________________

2 _______________________________________________________________________________________________________________________________________________________________

(Please provide transcripts of Awards obtained)

Part 6 NON REFUNDABLE APPLICATION & EXAM FEE

I would like to pay the following

AUD $ 55 for Application fee

plus AUD $ 99 for Student Membership

plus AUD $___________ = _______ units x AUD $55

TOTAL AUD $___________ fees payable to CMA Australia by

[ ] Application fees paid to CMA Australia Recognised Provider Institution in local currency _________________________________________________________________

[ ] Bank Draft payable to - Institute of Certified Management Accountants (Aus)

Cheque Number __________________________ Bank __________________________________________________________________ Date_____________________________

[ ] MasterCard [ ] Visa

Card No. ____ ____ ____ ____-____ ____ ____ ____-____ ___ ____ ____-____ ____ ____ ____ Expiry Date _______________

Cardholder Name _______________________________________________________________ Signature ______________________________________________________

Part 7 ACCEPTANCE OF RULES

I ___________________________________________________________________________ (name) desire to become a student member with the CMA Australia. In the

event of my admission as a member, I agree to be bound by the Rules of the Institute of Certified Management Accountants for the time being in force.

Signature of Applicant _______________________________________________________________________________________________ Date _____________________________________

2

Application Checklist

Duly filled form & application fees

Signatures (part 7)

CV (maximum 5 pages)

Copy of academic transcripts

Copy of membership certificates

Other supporting documents

The Executive Director,

The Institute of Certified Management Accountants

CMA House, Unit 5, 20 Duerdin Street,

Clayton North, Victoria 3168, AUSTRALIA.

Phone +61 (3) 85550358 Fax +61 (3) 85550387

Email: info@cmawebline.org Web: www.cmawebline.org

Send all applications by fax, scan

& email, or mail to:

CMA Australia Head Office

or

Any of our Recognised Provider

InstitutionsCM

A A

ust

ralia

Stu

den

t an

d E

xam

Reg

istr

ati

on

Fo

rm

S������ M��������� � E��� R�����������