Association of Chartered Islamic Finance Professionals APPLICATION FOR ADMISSION TO MEMBERSHIP To: The President Association of Chartered Islamic Finance Professionals (ACIFP) Please affix recent
passport photograph
Name: ________________________________________________________ ACIFP Membership Committee ACIFP Council We hereby verify that the applicant has Endorsed by Council at its meeting held on complied with all the requirements to be ____________________________. admitted as a member of ACIFP. Endorsed by: Verified by: ________________________________ (1)_______________________ (2)_________________________ Secretary Chairman Secretary Membership No.: ____________________ Date: Certificate Serial No.: _____________________ Date Issued: ______________________ nd
The Association of Chartered Islamic Finance Professionals, 2 Floor, Annexe Block, Menara Tun Razak, Jalan Raja Laut, 50350
Kuala Lumpur. Tel: 603 2781 4000 Fax: 2692 4094
(Please refer to the accompanying notes before completing this form.) Section 1 Please tick (√) category of membership applied for: Associate member Proficient member Practising member Section 2 Personal Information Name Preferred title Mr / Mrs / Ms / Dr / Prof Other: Date of Birth Identity Card or Passport No. CIFP Student No. Residential Address: Business Address: Telephone Telephone Email Fax Preferred address for correspondence (please tick) Residential Address Business Address Section 3 Academic Qualifications Please indicate below your academic qualifications (tertiary).
Name of University / College Title of Degree / Diploma Date Completed nd
The Association of Chartered Islamic Finance Professionals, 2 Floor, Annexe Block, Menara Tun Razak, Jalan Raja Laut, 50350
Kuala Lumpur. Tel: 603 2781 4000 Fax: 2692 4094
Section 4 Professional Qualifications Date examination Designatory completed title/letter Name of professional body Section 5 Date elected to membership Employment History Please state below your employment in the last five (5) years starting with your current position. You are welcomed to supply a curriculum vitae instead of completing this section if you prefer. Date From To Section 6 Name and Address of Employer Nature of Business Position held Fees For payment of the current annual membership fee via (please tick ONE box only): Cash Please do not send any cash by post. Cheque Enclosed is a crossed cheque No. _____________________ for RM_____________ made payable to “ACIFP”. nd
The Association of Chartered Islamic Finance Professionals, 2 Floor, Annexe Block, Menara Tun Razak, Jalan Raja Laut, 50350
Kuala Lumpur. Tel: 603 2781 4000 Fax: 2692 4094
Section 7 Declaration by Applicant I hereby declare that: i.
all information contained herein is true, accurate and complete to the best of my knowledge and belief. I understand that any false and/or misleading statement in this form could lead to disciplinary action being taken against me and/or may invalidate any decision reached on this application. ii.
I am not an undischarged bankrupt. iii.
I have not been convicted of any offence by any court of law involving fraud or dishonesty punishable on conviction with imprisonment for three (3) months or more.
I have read the accompanying notes and undertake that if admitted as a member of ACIFP, I will, so long as I remain a member of ACIFP, abide by the Constitution, Bye‐laws and all regulations made thereunder that are now in force or may hereafter from time to time be made. ___________________________________________ (Signature of Applicant) ____________________________ (date) nd
The Association of Chartered Islamic Finance Professionals, 2 Floor, Annexe Block, Menara Tun Razak, Jalan Raja Laut, 50350
Kuala Lumpur. Tel: 603 2781 4000 Fax: 2692 4094
THE ASSOCIATION OF CHARTERED ISLAMIC FINANCE PROFESSIONALS (ACIFP) Notes For The Completion Of the Membership Form Please read the following notes before completing the form. If you have any queries regarding your application or would like to discuss any aspect of it, please do not hesitate from calling or writing to our Membership Department for advice. You are required to complete the form in CAPITAL LETTERS. Notes for Section 1: There are two routes to membership. Route 1 Those who pass the Chartered Islamic Finance Professional (CIFP) Programme examinations shall be eligible to be admitted to the following categories of membership: Membership Requirements Professional Category of Membership Designatory Initials Practising Member Passed CIFP Programme Parts 1, 2 and CIFP 3. Proficient Member Passed CIFP Part 1 and 2
Associate Member Passed CIFP Part 1 No designatory initials No designatory initials Route 2 A person possessing qualifications and experience deemed acceptable by the Council may be eligible to be admitted as a Practising Member of ACIFP: Notes to Section 2 1. Identity Card or Passport No. – For nationals of countries that do not issue identity cards, other forms of identification will suffice, for example, passport, driving license, social security number etc. The purpose of requesting this is to authenticate your identity. 2. CIFP Student No. – Please indicate your CIFP Student No. if you are a student of the CIFP Programme. nd
The Association of Chartered Islamic Finance Professionals, 2 Floor, Annexe Block, Menara Tun Razak, Jalan Raja Laut, 50350
Kuala Lumpur. Tel: 603 2781 4000 Fax: 2692 4094
Notes to Section 3 1. Please indicate clearly the dates of completion for CIFP Part I, II and/or III. 2. You are required to submit copies of all certificate/transcripts from the institutions mentioned in this section, particularly your CIFP transcripts. Notes to Section 5 1. Your employment history will be considered particularly if you are seeking admission to membership via Route 2. Relevant experience can be obtained in one or more relevant organizations. Relevant organizations shall mean banks, companies, legal firms, accountancy/consultancy practices or organizations involved in the Islamic financial services industry. 2. You could also attach reference letters from previous employers which clearly shows the post held, dates of commencement and resignation. Notes to Section 6 1. Please note the table of fees below: Type of membership Fee Payable Per Year No. 1. Practising Member RM400 2. Proficient and Associate Member
RM100 Half year subscriptions will apply to all memberships starting on or after 1 July. The completed form and supporting documentation should be sent to: The Association of Chartered Islamic Finance Professionals (ACIFP) 2nd Floor, Annexe Block, Menara Tun Razak Jalan Raja Laut, 50350 Kuala Lumpur. nd
The Association of Chartered Islamic Finance Professionals, 2 Floor, Annexe Block, Menara Tun Razak, Jalan Raja Laut, 50350
Kuala Lumpur. Tel: 603 2781 4000 Fax: 2692 4094