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niet NATIONALINSTFIUTE OF [ACCOUNTING TECHNICANS, Webste: ww:ioteduph. + infopniatedu.ph [NATIONAL INSTITUTE OF ACCOUNTING TECHNICIANS IN THE PHILIPPINES East Tower, Phppine Stock Exchange Center, Oigas, Pasig City Tol. No, (632) 6379375 + Fax No, (632) 7062212 INTERNATIONAL CERTIFICATION APPLICATION FORM. PERSONAL DATA Student NrMtsMrs/Missr._ASS___LasuFamiyNametSumame:_Alberea FirvGiven Name, Sofia mae Mie Name:__ Nacional Sut «© Professional (Date of Birth (mmiddiyyyy): 03 /_ 43 1/2001 19 Duly filed up application form © Application Membership Fee wv {Soft Copy of Academic Credentials (any ofthe folowing) Calaar Dons, Teen Recs, PRE tert conrtary Cole, Ot Spring Dime ‘BACHELOR'S DEGREE Course Univer IAT TRANG PROVICER: PAYMENT INFORMATION ‘© NAT Membership (MAT E-Certfeate) Shwe HED Reno PAPIS0D ‘+ CAT Levelt Package (cluding NUAT mambership and courier fox) hee PEMD Renew SOD + CAT Level 2 Package (eluding NIAT membership and cour fe) ‘> New PHESO00 o Rane PSO ‘*CATLLevala including NAT membership and cour fee) Ne P2000 Renew HPO Ne PAPI Renew PAPTSOD 2 Popes New PPS Ramen P5000 For NIAT Member ONLY: Pippa Poe Please indeate COMPLETE mang address and conic numbers. Home / Bldg. No., Steet:_@izal Extension Ctreet BOO). District T City; _ Pastner Postal Code: Leyte Phone Number (Home): Province: ost wh Phone Number (Office): _ NIA E-mail Address: _ 20192104 @ spsps. edu- ph ‘Alternate E-mail Address: _allercacofiamaeaxG gmail.com Mobile Number: _ 04159529413 Alternate Mobile Number, 07991055423 Note: Please contact NAT Ofice mec fr any changes on your contact Information to ensue fimly dlvery of membership dociments. DELIVERY OF CERTIFICATE AND ID ‘Allmembership Ds end certiicates shall be delivered via LBC Courier, © Certiicstes and NIAT MembershipIDs challbe delvered by LBC. 2.Allretum to sender documents shall be at LBC’s safekeeping, Members ‘shallbe advised to schedule pick up atthe nearest LBC branches within 3

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