NATIONAL INSTITUTE OFACCOUNTING TECHNICIANS IN THE PHILIPPINES

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East Tower, Philippine Stock Exchange Center, Ortigas, Pasig City
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Tel. No. (632) 6379375 • Fax No. (632) 7062212
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Website: www.ni a t.e d u.p h • info@ni a t.e du .ph
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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 CONT A C T INFOR MA T IO N

□ Duly filled up application form
□ Application/Membership Fee Please indicate COMPL ET E mailing addres s and contact numb e rs .
□ CV
Home / Bldg. No., Street:
□ 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

□ BACHELOR’S DEGREE Year:
City:
Course:
Province: Postal Code:
University:
□ CPA License No.: Year: Phone Number (Home):
NIAT T RAININ G PROVID E R:
Phone Number (Office):
PAYMENT INFORMATION E-mail Address:
• NIAT Membership (NIAT E-Certificate)
Alternate E-mail Address:
□ New: PHP1500 □ Renewal: PHP1500
• CAT Level 1 Package (including NIAT membership and courier fee)
Mobile Number:
□ New: PHP5800 □ Renewal: PHP5800
• CAT Level 2 Package (including NIAT membership and courier fee)
Alternate Mobile Number:
□ Australia

□ New: PHP12300 □ Renewal: PHP12300

□ Philippines Note: Please contact NIAT Office imme di at el y for any changes on your contact
□ New: PHP5300 □ Renewal: PHP5300 information to ensure timely delivery of membership documents.
• CAT Level 3 Package (including NIAT membership and courier fee)
□ Australia
□ New: PHP12300 □ Renewal: PHP12300 DELIVERY OF CERTIFICATE AND ID
□ Canada
□ New: PHP7800
1. All certificates shall be delivered via LBC Courier.
□ Philippines
□ New: PHP5300 □ Renewal: PHP5300 • Certificate with title 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: PHP4300 □ Renewal: PHP4300
days. NIAT shall not be liable for any loss, damage, or delay in delivery of the
□ CAT Level 2
□ Australia documents.
□ New: PHP10800 □ Renewal: PHP10800
□ Philippines
□ New: PHP3800 □ Renewal: PHP3800 PAYMENT OPTIONS
□ CAT Level 3
□ Australia
□ New: PHP10800 □ Renewal: PHP10800 1. Direct deposit at any BDO branches:
□ Canada Bank name: BDO
□ New: 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.

Signature Date:

OF F ICI A L USE ONL Y : APPLI CA T I O N RECEI V E D ON:

INVOICE NO. INVOI C E DAT E: □ COMPLETED REQUIRED DOCUMENTS
OR NO. DATE PAID: □ APPROVED MEMBERSHIP NO.
DCR NO. VERIFIED: □ NOT APPR OV E D REASON: