NATIONAL INSTITUTE OF ACCOUNTING 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
Website: www.niat.edu.ph • info@niat.edu.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 CONTACT INFORMATION

□ Duly filled up application form
□ Application/Membership Fee Please indicate COMPLETE mailing address and contact numbers.
□ 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 TRAINING PROVIDER: _____________________________________________
Phone Number (Office): __________________________________
PAYMENT INFORMATION E-mail Address: ________________________________________
 NIAT Membership (Including courier fee)
Alternate E-mail Address: ________________________________
□ New: PHP1500 □ Renewal: PHP1500
 CAT Level 1 Package (including NIAT membership and courier fee) Mobile Number: ________________________________________
□ New: PHP4500 □ Renewal: PHP4500
 CAT Level 2 Package (including NIAT membership and courier fee) 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.

Signature _____________________________________________________ Date: _____________________________________________________

OFFICIAL USE ONLY: APPLICATION RECEIVED ON: __________________

INVOICE NO. ________________ INVOICE DATE: ___________________________ □ COMPLETED REQUIRED DOCUMENTS
OR NO. ____________________ DATE PAID: ______________________________ □ APPROVED MEMBERSHIP NO. ______________
DCR NO. ___________________ VERIFIED: _______________________________ □ NOT APPROVED REASON: _____________________