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Workshop Facilitators of the Qualification Programme Application Form

Part A: Personal Information

Surname *This question is required.

Given name *This question is required.

HKICPA membership number *This question is required.

Practising Certificate number (if applicable)

Email address *This question is required. This question requires a valid email address.

Mobile number *This question is required. This question requires a valid number format.

Company name *This question is required.

Position *This question is required.

Part B: Declaration
*This question is required.

Space Cell	No	Yes
1. Have you previously applied for the position of Workshop Facilitator?	1. Have you previously applied for the position of Workshop Facilitator?: No	1. Have you previously applied for the position of Workshop Facilitator?: Yes
2. Have you ever registered as a student of the QP?	2. Have you ever registered as a student of the QP?: No	2. Have you ever registered as a student of the QP?: Yes
3. Have you ever been reprimanded, warned about conduct and discipline related matters or publicly sanctioned by any professional or regulatory body?	3. Have you ever been reprimanded, warned about conduct and discipline related matters or publicly sanctioned by any professional or regulatory body?: No	3. Have you ever been reprimanded, warned about conduct and discipline related matters or publicly sanctioned by any professional or regulatory body?: Yes
4. Have you ever been investigated on allegations of misconduct or malpractice in connection with professional or business activities which resulted in a formal complaint being made against you, whether or not the complaint was proved or an order was made against you?	4. Have you ever been investigated on allegations of misconduct or malpractice in connection with professional or business activities which resulted in a formal complaint being made against you, whether or not the complaint was proved or an order was made against you?: No	4. Have you ever been investigated on allegations of misconduct or malpractice in connection with professional or business activities which resulted in a formal complaint being made against you, whether or not the complaint was proved or an order was made against you?: Yes
5. Have you ever been convicted of a criminal offence?	5. Have you ever been convicted of a criminal offence?: No	5. Have you ever been convicted of a criminal offence?: Yes

Part C: Experience and Qualification

Year(s) of Working Experience *This question is required.

Space Cell	Year(s)
Auditing / Assurance	Auditing / Assurance: Year(s)
Corporate Finance / Finance Management	Corporate Finance / Finance Management: Year(s)
Financial Reporting	Financial Reporting: Year(s)
Hong Kong Taxation	Hong Kong Taxation: Year(s)
Others, please specify	Others, please specify: Year(s)

Year(s) of lecturing / tutoring / training experience (if any):

Subject(s) taught (if applicable):

Professional qualification other than Hong Kong Institute of CPAs, please specify (if any):

Highest education qualifications: *This question is required.

Part D: Areas of Expertise

(tick one or more where appropriate) *This question is required.

Accounting Standards
Audit / Assurance
China Taxation
Corporate Governance
Financial Analysis
Financial Reporting
Hong Kong Taxation
Treasury
Others, please specify (if any) Please enter an 'other' value for this selection.

Part E: Indication of Interest

(tick one or more where appropriate) *This question is required.

Applicant's Signature

Clear

Signature of

1. Please upload your resume in PDF format. *This question is required.

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