Fillable Certificate of Professional Achievement (CPA) Application Form (University of Aberdeen)

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Certificate of Professional Achievement (CPA) Application Form (University of Aberdeen)

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The Certificate of Professional Achievement (CPA) Application Form (University of Aberdeen) form is 3 pages long and contains:

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  • 24 check-boxes
  • 37 other fields

Country of origin: UK
File type: PDF

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Certificate of Professional Achievement (CPA) Application Form
Please save a copy of this form to your computer and complete it on-screen before emailing it to sps@libf.ac.uk
Alternatively, you can print a copy to complete in BLOCK capitals and scan and email it to sps@libf.ac.uk or post to
Student and Customer Services, The London Institute of Banking & Finance, 4–9 Burgate Lane, Canterbury, Kent CT1 2XJ United Kingdom
The London Institute of Banking & Finance is a registered charity, incorporated by Royal Charter.
1
YOUR DETAILS
Membership number (If known) ___________________________________________ Title (Mr/Mrs/Ms etc) _____________________________________________
First name(s) / Given name(s) ____________________________________________________________________________________________
Last name / Family name _______________________________________________________________________________________________
Previous name (Please tell us any previous name you have used that would help us link this registration to any other records we may hold for you)
_____________________________________________________________________________________________________________________
Date of birth* (DD/MM/YYYY) ____________________________________________________ Gender Male n Female n
*A date of birth is compulsory to activate your online account.
YOUR DETAILS
YOUR DETAILS
Email address* _________________________________________________________________________________________________________________________________
Please provide a telephone number we can use to contact you if necessary:
Telephone no. _______________________________________________ Mobile no. (if different from Telephone no.) _________________________________________
*Please note that having a valid email address is a compulsory requirement of using LIBF CPA Services.
CONTACT DETAILS
YOUR DETAILS
Job title _______________________________________________________________________________________________________________
Employer / business name _______________________________________________________________________________________________
EMPLOYMENT
YOUR DETAILS
Business address ________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
Postcode / Zipcode
_____________________________________________________ Country _____________________________________________________
Home address ________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
Postcode / Zipcode
_____________________________________________________ Country _____________________________________________________
Please indicate which address you would prefer us to use for postal correspondence: Business n Home n
ADDRESS DETAILS
YOUR DETAILS
Please indicate which of the following approved Level 4 qualifications you currently hold:
n
Diploma for Financial Advisers (DipFA
®
) – registered after 1 April 2010
n
Diploma for Financial Advisers (DipFA
®
) – registered before 1 April 2010 plus appropriate qualification ‘gap-fill’
(see guidance note 4c)
n
Diploma in Mortgage Advice and Practice (DipMAP
®
)
n
Diploma in Retail Banking Conduct of Business (DipRBCB
®
)
n
Qualification from another provider, please state
If you have answered ‘Qualification from another provider’ you are required to submit a certified copy of your qualification certificate
Previous SPS - please note that a CPA is not a form of SPS. Practicing advisers need an SPS.
QUALIFICATION DETAILS
YOUR DETAILS
n
I declare that the information contained in this form is true and accurate
n
I declare that in the preceding twelve months I have completed a programme of Continuing Professional Development that meets the
standards set by The London Institute of Banking and Finance. I will continue to undertake an annual programme of CPD in order to
retain the CPA certificate.
n
I agree to abide by The London Institute of Banking & Finance Code of Ethics.
n
I accept the Terms and Conditions.
Signed______________________________________________________________________ Date ________________________________
DECLARATION
YOUR DETAILS
Membership of The London Institute of Banking & Finance provides access to benefits that address the specific needs of the financial and
mortgage adviser community. Membership costs £82 per annum.
n
I would like to apply for membership of The London Institute of Banking & Finance £82
n I would like to pay by debit/credit card*
n
I would like to pay monthly installments of £6.83 x 11 and 1 x £6.87 for the direct debit (please complete the direct debit
instruction below)
n
I would like to pay annually via direct debit (please complete the direct debit instruction below)
n
I would like to pay by cheque (cheque enclosed)
*If paying by debit/credit card we will contact you by telephone to take the details of your card.
Signed ______________________________________________________________________________ Date ____________________________________
MEMBERSHIP
2
YOUR DETAILS
We will use and protect your personal data in accordance with current data protection legislation to process your application and manage
the provision of membership and/or CPD services Further details, including your rights, the disclosure of data to third parties, storage,
retention and how to amend your personal data, can be found within our Privacy Notice.
USING YOUR PERSONAL INFORMATION
YOUR DETAILS
n
Member* £47
n
Non-member £88
* If you are not yet a member but would like to become one you
can do so by completing the Membership application section at
the end of this form.
Your SPS will be available to download (in PDF format) once your
application has been successfully processed and is valid for a period
of 12 months.
n
Please tick here if you would like a paper copy posted to you
£12
TOTAL
£ ____________
YOUR
n
I enclose a cheque for the total payable, made payable to
The London Institute of Banking & Finance
n I would like to pay by debit/credit card
We will contact you by telephone to take the details of your
card. We regret that your CPA cannot be paid by direct debit.
CPA PAYMENT INFORMATION
BANKS AND BUILDING SOCIETIES MAY NOT ACCEPT DIRECT DEBIT INSTRUCTIONS FOR SOME TYPES OF ACCOUNT
YOUR DETAILS
The Direct Debit Guarantee
n This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
n If there are any changes to the amount, date or frequency of your Direct Debit The London Institute of Banking & Finance will notify
you 10 working days in advance of your account being debited or as otherwise agreed. If you request The London Institute of
Banking & Finance to collect a payment, confirmation of the amount and date will be given to you at the time of the request
n If an error is made in the payment of your Direct Debit, by The London Institute of Banking & Finance or your bank or building society,
you are entitled to a full and immediate refund of the amount paid from your bank or building society - If you receive a refund you
are not entitled to, you must pay it back when The London Institute of Banking & Finance asks you to
n You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required.
Please also notify us.
THE DIRECT DEBIT GUARANTEE (THIS GUARANTEE SHOULD BE DETACHED AND RETAINED BY THE PAYER)
YOUR DETAILS
Please fill in the form and send to The London Institute of Banking
& Finance, 4-9 Burgate Lane, Canterbury, Kent CT1 2XJ
Name(s) of account holders
____________________________________________________________________
____________________________________________________________________
Bank or building society account number
n n n n n n n n
Branch sort code
nn-nn-nn
Name and full postal address of your bank or building society
Instruction to your bank or building
society to pay by direct debit
Service User No
nnnnnn
Reference
_____________________________________________________________________
Instruction to your bank or building society
Please pay The London Institute of Banking & Finance Direct
Debits from the account detailed in this instruction subject to the
safeguards assured by The Direct Debit Guarantee. I understand
that this instruction may remain with The London Institute of
Banking & Finance and, if so, details will be passed electronically
to my bank/building society.
Signature(s)
______________________________________________________________________
Date
___________________________
DIRECT DEBIT INSTRUCTION FOR MEMBERSHIP (UK BANK OR BUILDING SOCIETY ACCOUNTS ONLY)
99034 6
To: The Manager Bank/Building Society
___________________________________________________________________
Address
___________________________________________________________________
___________________________________________________________________
_________________________________ Postcode_______________________
AH03/20
3
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Certificate of Professional Achievement (CPA) Application Form (University of Aberdeen)

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Completed 4 February 2021

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