NATIONAL INSTITUTE OF ACCOUNTING TECHNICIANS IN THE PHILIPPINES

Attach 1x1 ID
505 East Tower, Philippine Stock Exchange Center, Ortigas, Pasig City
picture with
Tel. No. (632) 6379375 Fax No. (632) 7062212
Website: www.niat.edu.ph info@niat.edu.ph
white
background

INTERNATIONAL CERTIFICATION APPLICATION FORM

PERSONAL DATA
Student Mr./Ms./Mrs./Miss/Dr. ______________ Last/Family Name/Surname: ____________________________________________
First/Given Name: ________________________ Middle Name: ____________________________ Suffix: _____________
Professional
Date of Birth (mm/dd/yyyy): ____ / ____ / ____ /

APPLICATION CHECKLIST CONTACT INFORMATION

Duly filled up application form
Application/Membership Fee Please indicate COMPLETE mailing address and contact numbers.
Signature
Home / Bldg. No., Street: _________________________________
CV
Soft Copy of Academic Credentials (any of the following): College Diploma, _____________________________________________________
Transcript of Records, PRC ID/Board of Accountancy Certificate, Other Supporting Documents
_____________________________________________________
EDUCATION & PROFESSIONAL INFORMATION
BACHELORS DEGREE Year: __________________
__________________________________ City: _______________
Course: ______________________________________________________________ Province: ____________________ Postal Code: ______________
University: ____________________________________________________________
CPA License No.: __________________________ Year: __________________ Phone Number (Home): __________________________________
NIAT TRAINING PROVIDER: _____________________________________________
Phone Number (Office): __________________________________
PAYMENT INFORMATION E-mail Address: ________________________________________
NIAT Membership (Including courier fee)
Alternate E-mail Address: ________________________________
New: PHP1500 Renewal: PHP1500
New/Pick up: PHP1200 Renewal Pick up: PHP1200
Mobile Number: ________________________________________
CAT Level 1 Package (including NIAT membership and courier fee)
New: PHP4500 Renewal: PHP4500
Alternate Mobile Number: ________________________________
New/ Pick up: PHP4200 Renewal/Pick up: PHP4200
CAT Level 2 Package (including NIAT membership and courier fee)
Note: Please contact NIAT Office immediately for any changes on your contact
New: PHP11000 Renewal : PHP11000
New/Pick up: PHP10700 Renewal/Pick up: PHP10700 information to ensure timely delivery of membership documents.
CAT Level 3 (including NIAT membership and courier fee)
New: PHP3500 (Philippines)
CAT Level 3 (including NIAT membership and courier fee)
DELIVERY OF CERTIFICATE AND ID
AUS
New: PHP7500 Renewal: PHP8500 1. All membership IDs and certificates shall be delivered via LBC Courier.
New/Pick up: PHP7200 Renewal/Pick up: PHP8200
CND Certificates and NIAT Membership IDs shall be delivered by LBC.
New: PHP7500 Renewal: PHP7500
2. All return to sender documents shall be at LBCs safekeeping. Members
New/Pick up: PHP7200 Renewal/Pick up: PHP7200
shall be advised to schedule pick up at the nearest LBC branches within 3
For NIAT Member ONLY: days. NIAT shall not be liable for any loss, damage, or delay in delivery of the
CAT Level 1
New/Renewal: PHP3300 documents and IDs.
Pickup: PHP 3000
CAT Level 2
New/Renewal: PHP9800 PAYMENT OPTIONS
Pickup: PHP9500
CAT Level 3
1. Direct deposit at any BDO branches:
(AUS)
New: PHP 6300 Renewal: PHP7300 Bank name: BDO
New Pick up: PHP6000 Renewal Pick up: PHP7000
Account name: National Institute of Accounting Technicians of the
(CND) Philippines, Inc.
New/ Renewal: PHP 6300
Account No.: 343-006-8384
New/ Renewal Pick up: PHP6000
2. Payment at NIAT office.

ACCEPTANCE OF SUBSCRIPTION
I declare that all of the information contained in this application is true and correct and I agree to provide any supporting documentation requested by the Institute. If accepted, I
agree to abide by the National Institute of Accounting Technicians Code of Professional Conduct and Continuing Professional Education requirements. I understand that I must
renew my subscription annually to enjoy the services provided by the Institute including eligibility privileges and retention of professional designation.

Signature _____________________________________________________ Date: _____________________________________________________

OFFICIAL USE ONLY: APPLICATION RECEIVED ON: __________________

INVOICE NO. ________________ INVOICE DATE: ___________________________ COMPLETED REQUIRED DOCUMENTS
OR NO. ____________________ DATE PAID: ______________________________ APPROVED MEMBERSHIP NO. ______________
DCR NO. ___________________ VERIFIED: _______________________________ NOT APPROVED REASON: _____________________