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    IIA Registration

    Uploaded by

    John Cramwell
    The document is a membership application form for the Institute of Internal Auditors (Ghana). It requests information such as personal details, education history, employment history, and professional qualifications from applicants. Applicants must also declare that they will abide by the Institute's code of ethics and provide signatures and documentation to verify their application.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    IIA Registration

    Uploaded by

    John Cramwell
    117 views3 pages
    The document is a membership application form for the Institute of Internal Auditors (Ghana). It requests information such as personal details, education history, employment history, and professional qualifications from applicants. Applicants must also declare that they will abide by the Institute's code of ethics and provide signatures and documentation to verify their application.

    Original Description:

    Institute of Internal Auditors, Ghana - Registration form

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    The document is a membership application form for the Institute of Internal Auditors (Ghana). It requests information such as personal details, education history, employment history, and professional qualifications from applicants. Applicants must also declare that they will abide by the Institute's code of ethics and provide signatures and documentation to verify their application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    117 views3 pages

    IIA Registration

    Uploaded by

    John Cramwell
    The document is a membership application form for the Institute of Internal Auditors (Ghana). It requests information such as personal details, education history, employment history, and professional qualifications from applicants. Applicants must also declare that they will abide by the Institute's code of ethics and provide signatures and documentation to verify their application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    THE INSTITUTE OF INTERNAL AUDITORS (GHANA)

    2nd Floor, CLOGSAG Building, Ministries Enclave, Accra


    P.O. BOX SD 173, STADIUM, ACCRA, GHANA
    Tel: +233-30-2684879 Fax: +233-30-2684879
    Website: www.iiaghana.com.gh Email: [email protected]

    MEMBERSHIP APPLICATION FORM


    For Office Use Only
    IIA Membership Number………………..

    Please Type or Print Clearly and Tick Appropriate Box

    BUSINESS DATA
    Preferred Title: Mr. Mrs. Ms. Miss Others (Specify)...………………………….

    Name……………………………………………………………………………………………………………………...
    (Surname) (First Name) (Middle Names)

    Previous Full Name……………………………………………………………………………………………................

    Organisation………………………………………………… Job Title………………………………………………..

    Business Address ………………………………………………………………………………………………………...

    …………………………...………………………………………………………………………………………………..

    Office Telephone No………………… ………… Fax No………………………………………………....

    Mobile Phone No………………………………… E-Mail…………………………………………………

    PERSONAL DATA
    Residential Address………………………………………………………………………………………………………

    ………………………………………………………………………………………………................

    Telephone No………………… Fax………………. E-Mail……………………................

    * Send Mail to : Business Address Residential Address

    Date of Birth………………………………. Sex : Male Female

    Marital Status : Married Single Nationality……………………………………………………

    Have you been convicted of any felony? Yes No

    Institute of Internal Auditors (Ghana) Membership Registration Form Page 1 of 3


    EDUCATION

    Schools and Colleges Attended


    Name of Institution Location Month/Year Month/Year
    From To
    ……………………………….. ………………. …………… …………..

    ……………………………….. ………………. …………… …………..

    ……………………………….. ………………. …………… …………..

    ……………………………….. ………………. …………… …………..

    Educational Qualification
    ( Highest Qualification First)

    Qualification/Certificate Date Obtained

    …………………………………………………………… …………………

    …………………………………………………………… …………………

    …………………………………………………………… …………………

    …………………………………………………………… …………………

    Professional Qualifications Date Obtained


    …………………………………………………………… …………………

    …………………………………………………………… …………………

    …………………………………………………………… …………………

    Management and Refresher Courses Attended

    Course Date Attended


    …………………………………………………………… …………………

    …………………………………………………………… …………………

    …………………………………………………………… …………………

    Other Training

    Training Programme Date Attended


    …………………………………………………………… …………………

    …………………………………………………………… …………………

    …………………………………………………………… …………………

    Institute of Internal Auditors (Ghana) Membership Registration Form Page 2 of 3


    Membership of Professional Associations
    ………………………………………………………………………………………………………

    ………………………………………………………………………………………………………

    ………………………………………………………………………………………………………

    ………………………………………………………………………………………………………

    CURRENT AND PREVIOUS EMPLOYMENT DATA


    Name of Organisation Position Held Month/year Month/year
    From To

    ………………………………… ………………….. …………….. ………………

    ………………………………… ………………….. …………….. ………………

    ………………………………… ………………….. …………….. ………………

    ………………………………… ………………….. …………….. ………………

    DECLARATION
    I declare that:
    1. All information contained on this application is true and correct.
    2. If accepted, I agree to abide by the Code of Ethics adopted by the Institute of Internal Auditors to govern its
    members.

    Applicant’s Signature………………………….. Name of Head of Dept……………………………………………...

    Date………………………… Signature……………………………………………………………

    Date…………………………………………………………………
    * Signature should bear Head of Dept’s. stamp

    NB. Completed Application Forms should be forwarded to the IIA Secretary together with the following:
    1. Photocopies of your Certificates
    2. One Passport size photograph endorsed by your Head of Department

    Office Use Only

    Date Received…………………………… Recommended Class of Membership…………………………….

    Signature of President……………………………………

    Date……………..

    Institute of Internal Auditors (Ghana) Membership Registration Form Page 3 of 3

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