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NIAT Application Form
NIAT Application Form
NIAT Application Form
Attach 1x1 ID
East Tower, Philippine Stock Exchange Center, Ortigas, Pasig City
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Tel. No. (632) 6379375 • Fax No. (632) 7062212
Website: www.niat.edu.ph • info@niat.edu.ph
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_____________________________________________________
EDUCATION & PROFESSIONAL INFORMATION
□ BACHELOR’S DEGREE 2017
Year: __________________
__________________________________ City: _______________
San Enrique
Course: ______________________________________________________________
BS Accounting Technology Province: Negros
____________________ 6104
Postal Code: ______________
Occidental
University: ____________________________________________________________
University of St. La Salle - Bacolod
09455104576
Phone Number (Home): __________________________________
□ CPA License No.: __________________________ Year: __________________
NIAT TRAINING PROVIDER: _____________________________________________
USLS Bacolod
Phone Number (Office): __________________________________
PAYMENT INFORMATION E-mail Address: ________________________________________
korina.vilchez@gmail.com
NIAT Membership (Including courier fee)
Alternate E-mail Address: ________________________________
kokie_vilchez@yahoo.com
□ New: PHP1500 □ Renewal: PHP1500
CAT Level 1 Package (including NIAT membership and courier fee) 09455104576
Mobile Number: ________________________________________
□ New: PHP4500 □ Renewal: PHP4500
CAT Level 2 Package (including NIAT membership and courier fee)
09279167370
Alternate Mobile Number: ________________________________
□ Australia
□ New: PHP10000 □ Renewal: PHP10000
Note: Please contact NIAT Office immediately for any changes on your contact
□ Philippines
□ New: PHP5000 □ Renewal: PHP5000 information to ensure timely delivery of membership documents.
CAT Level 3 (including NIAT membership and courier fee)
□ Australia
□ New: PHP10000 □ Renewal: PHP10000 DELIVERY OF CERTIFICATE AND ID
□ Canada
□ New: PHP7500 □ Renewal: PHP7500 1. All membership IDs and certificates shall be delivered via LBC Courier.
□ Philippines
□ New: PHP5000 □ Renewal: PHP5000 Certificates and NIAT Membership IDs shall be delivered by LBC.
2. All return to sender documents shall be at LBC’s safekeeping. Members
For NIAT Member ONLY:
□ CAT Level 1 shall be advised to schedule pick up at the nearest LBC branches within 3
□ New: PHP3300 □ Renewal: PHP3300
□ CAT Level 2
days. NIAT shall not be liable for any loss, damage, or delay in delivery of the
□ Australia documents and IDs.
□ New: PHP8800 □ Renewal: PHP8800
□ Philippines
□ New: PHP3800 □ Renewal: PHP3800 PAYMENT OPTIONS
□ CAT Level 3
□ Australia
□ New: PHP8800 □ Renewal: PHP8800 1. Direct deposit at any BDO branches:
□ Canada Bank name: BDO
□ New: PHP6300 □ Renewal: PHP6300
□ Philippines Account name: National Institute of Accounting Technicians of the
□ New: PHP3800 □ Renewal: PHP3800 Philippines, Inc.
Account No.: 343-006-8384
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 Technician’s 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.