Registration Form for CFA-FICS Research Programme

10 Shenton Way #13-02 MAS Building, Singapore 079117Tel: (65) 6323-6679 Fax: (65) 6323-7657Email: classes@cfasingapore.org / programs@cfasingapore.orgGST Registration No: M90365205TRegistration Form for CFA-FICS Research ProgrammeName: Dr/ Mr. / Mrs. / Ms. Gender: Male / Female Age:Membership No.: Candidate No.: (Intake Jun / Dec 20__) (Level: I / II)Identification Card/ Passport:Nationality:Mailing Address:Postal Code:Employer:Designation:Highest Qualification:Contact phone:Email:Where/How did you know about our CFA programme? You may tick more than one option below. Info Session / Preview Lecture Emailers CFA Singapore Website Google Ads Friends/Relatives MRT Advertisement Others, please specify:Select the level for CFA-FICS Research Programme. Please tick one option below (Level I)CodePrices effective 1 May 2013(Price payable includes GST)Total Course FeesTotal Course Fees -net of FundingTotalFICSECFA-FICS Research Programme Level IS$ 5,800(S$ 5,220 for members*)S$ 1,740(S$ 1,566 for members*) (Level II)CodePrices effective 1 May 2013(Price payable includes GST)Total Course FeesTotal Course Fees -net of FundingTotalFICSECFA-FICS Research Programme Level IIS$ 6,000(S$ 5,380 for members*)S$ 1,800(S$ 1,614 for members*)* Joining and membership fee until 30 th Jun 2014 is waived for FICS participants!Course Fees (Participants are required to pay the full course fees upfront)Top ups are not eligible for funding. Please refer to top up form for more details.Funding will only be reimbursed to participants who have successfully completed the programme. (Subject to the grant eligibility under the FSDF FICS FinancialTraining Scheme) Further information on funding eligibility can be found at www.fics.org.sg.Terms and Conditions:1. Participants are required to submit feedback for the tutorials and lecturers.2. Fees include training and study materials (lecture powerpoints, study guide, practice exam workbook and question databank),but exclude CFA Institute examination and registration fees.3. The minimum class size policy for the programme requires a minimum of ten confirmed registrations and it will be at the solediscretion of CFA Singapore whether to start a class without the minimum required class size.4. CFA Singapore may impose additional requirements or make changes to existing requirements.I understand and agree to the fulfillment of the terms and conditions stated. I also confirm that my personal informationas furnished above is accurate.Signature / Date

Payment Option 1:Full Payment of S$Cash / Cheque No.:_Credit Card(Cheque made payable to “CFA Singapore”)DBS / POSB credit card 6-months interest free installment planI, hereby authorize CFA Singapore to charge my credit card account for the amount$_SGD Credit Card (VISA/MC/Amex):________ ________ _______ ________ (Expiry: ___/20___)Payment Option 2:Payment in StagesPaymentfor:CODEst1 Payment: Upon Registration2 nd Payment: Within 1 week after theJun / Dec 20___ CFA exams% of Course Fees Amount (S$) % of Course Fees Amount (S$)FICSE 40% 60%Total AmountCash / Cheque No.:_Credit Card(Cheque made payable to “CFA Singapore”)DBS / POSB credit card 6-months interest free installment planI, hereby authorize CFA Singapore to charge my credit card account for the total amount$_SGD in 2 stages as stipulated aboveCredit Card (VISA/MC/Amex):_______ ________ _______ _______ (Expiry:___/20___)Payment and Refund Policy:Any notice of withdrawal must be given in writing via mail/email:1. Full refund, less 10% bank admin and admin charges, if notice given at least 2 weeks before commencement.2. 50% of programme fee if notice is given between 1-2 weeks before commencement.3. No refund if notice is given less than 1 week before commencement, or after commencement of programme.4. Study materials if issued, are refundable only when the packaging remains intact and before commencement of programme.5. I am liable to pay the balance amount (2 nd Payment) of the Research Programme in Jun / Dec 20___. In the event that I failto complete the training and / or fulfill the FICS funding criteria as stipulated in the Research Programme, I understand thatCFA Singapore has the right to recover the full course fees of the Research Programme.6. In the event that I withdraw from the Research Programme before its completion, I am liable to pay the balance amount(2 nd Payment) of the Research Programme immediately upon withdrawal.7. By selecting any of the Credit Card payment option, I authorize CFA Singapore to charge my credit card account for the balanceamount (2 nd Payment) when it is due in Jun / Dec 20___. CFA Singapore is not required to seek further authorization from meat that point in time.I understand and agree to the fulfillment of the payment and refund policy.Signature / Date