admission form_may 2013 exam diet docx new

7/29/2019 Admission Form_may 2013 Exam Diet Docx New

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APPLICATION FORM FOR STUDENT MEMBERSHIP

Note: Before completing this form the applicant should study the Instructions and Information givenbelow. The completed form should be lodged with the Institute at the below mentionedaddress only.

302, Indian Globe Chambers, 142, Fort Street, Off D N Road,

Near CST (VT) Station, Mumbai400001

Tel: 67843333 Ext. 301, Fax: 678443330

E-mail: [email protected]

Admission fees for student membership is as under:

Status

Total Admission Fees

inclusive of subscription

up to March 2013

Resident in India/ and members of otherSAARC Countries

Rs. 1000/-

Resident in rest of the World US $ 140/-

Note:

a) Please send the fee by demand draft/pay order in favor of 'Institute of Actuaries ofIndiapayable at Mumbai. Demand Draft should not be stapled but attached with a Upin.

b) During the Financial Year i.e. April to March, whenever the admission is taken, thesubscription will be applicable only for that financial year e.g.:- For admission taken on2nd March 2013 subscription will be valid till 31st March 2013. The subscription for 2013-2014 willbe due on 1stApril2013. For further details kindly contact Ms. Vijaya Bhosale [email protected]

c) If you wish to appear forMAY 2013 exam diet, the Institute should receive this form dulyfilled by 10th January 2013. Membership forms received after this date will be eligible to

appear for subsequent exam diets and NOT the May 2013 exam diet.

Affix YourPhotograph

here
mailto:[email protected]:[email protected]:[email protected]


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This form must be completed in full. Failure to do so will result in your form being returned.

Please use BLOCK CAPITAL and black ink when filling in this form.

Section 1Application Details

ACET Application Number:e.g: IAIEE-DEC12-2000

Title: Mr. Mrs. Miss Dr. Other Please specify: _________

Surname:

First Name:

Middle Name:

Short Name:

Father Name/ Husband Name:

Mothers Name:

Date of Birth:

D D M M Y Y Y Y

Nationality:

Failure to provide the correct correspondence address, telephone number and e-mail address,

in clear handwriting, will result in the applicant not receiving information about their

application form and forthcoming examination. So following information is Mandatory.

RESIDENTIAL ADDRESS

Name STD Code

Address Tel. No.

Mob No.

Pin Code

City State Country


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PERMANENT ADDRESSName STD Code

Address Tel. No.

Mob No.

Pin Code

City State Country

EMPLOYERS DETAILS, ifemployed.Name STD Code

Address Tel. No.

Fax No.

Pin Code

City State Country

Employee Code: ________________________ Employee Designation: __________________

E-mail ID : ___________________________________________________________________

(Alternate Email ID) ___________________________________________________________

Note: All the communication from IAI would be through email and hence it is essential that you mention your email id

Please indicate which address you would like all correspondence send to:

Office: Residence: Permanent Address:

Are you a member of any other actuarial association? If so, please give the followinginformation.

Name of the

Institute

Membership No. Membership Class Details of subject

passed


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Section 2Criteria for becoming Student Member

A person is eligible for admission if he/she satisfies the following condition:

1) Resident in India (irrespective of nationality of the applicant)a) Passed ACET Exam (or)

b) A student member from any of the following actuarial bodies provided at least onesubject has been passed from these bodies (not on exemption basis)

i) Institute and Faculty of Actuaries, UKii) Institute of Actuaries of Australia

iii) Society of Actuaries, USAiv) Casualty Actuarial Society, USA

2) Applicants of countries other than India should satisfy any one of the followingcriteria;

i) Passed 10+2(H.S.C) or equivalent with at least 85% in Mathematics/Statisticsii) Graduate or Post Graduate with Mathematical subjects. For this purpose

following subjects constitute mathematical subjects:

a) Mathematics or any of its branchesb) Statistics or any one of its sub classifications such as Mathematical Statistics and

Applied Statisticsc) Econometricsd) Computer Sciencee) Any discipline of Engineeringf) Subject in Science Such as Physics or its branches

The admission under these groups will, however be subject to the followingconditions:

i) The total marks secured in the subject coming under the clarification ofmathematical subjects taken together in all the years of the Degree course notless than 55%

ii) The content of Mathematical subjects content in all the years of the course takentogether is not less than 50% of the total content

iii) Fully qualified members of the following bodies in their respective countriesa. Institute of Chartered Accountants

b. Institute of Cost and Work Accountants


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iv) A student member from the following actuarial bodies provided at least one subjecthas been passed from the bodies (not on exemption basis)

a) Institute and Faculty of Actuaries, UKb) Institute of Actuaries of Australiac) Society of Actuaries, USAd) Casualty Actuarial Society, USA

Please note that medium of instruction in final state of examination based on which admission issought should be English.

Section 3Documents to be submitted

The documents which are required to be submitted along with Admission Application form;

Sr.

No

Category under which

application is made

Attested Photocopies Required

Resident in India (irrespective of nationality of the applicant)

1) ACET1) Photocopy of your ACET registration

form and result highlighting your name.( unattested)

2) HSC (10+2)Marksheet and PassingCertificate and Proof of English as one of

the subject

2) -Institute and Faculty ofActuaries UK,

- Society of Actuaries, US

- Institute of Actuaries of

Australia

- Casualty Actuarial Society,

US

Certificate of Passing of any 1 subject alongwith the proof of membership

3) Applicable educationalqualification Mark-sheet & Passing Certificate and Proofof English as one of the subject

Compulsory Documents for all categories of membership

4) Proof of Age Birth Certificate / School Leaving Certificatecontaining date of birth

5) Passport Size RecentPhotographs

Two

6) Change in Name If there is change in name then documentaryevidence such as marriage certificate,

Affidavit is required for the same.Optional Documents for all categories of membership


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1) HSC(10+2) Marksheet and Passing Certificate

2) Graduation Marksheet and Passing Certificate of all

years/semesters.

3) Post Graduation Marksheet and Passing Certificate of allyears/semesters.

4) Professional Qualification Proof of Membership and Marksheet andPassing Certificate.

Resident outside India

1) HSC(10+2) Marksheet and Passing

2) Graduation Marksheet and Passing Certificate of all

years/semesters.3) Post Graduation Marksheet and Passing Certificate of all

years/semesters.

4) Fully Qualified Members ofInstitute of Chartered

Accountants and Institute of

Cost and Work Accountants

Proof of Membership and Marksheet andPassing Certificate.

5) -Institute and Faculty ofActuaries UK,

- Society of Actuaries, US- Institute of Actuaries of

Australia

- Casualty Actuarial Society,

US

Certificate of Passing of any 1 subject alongwith the proof of membership

Note. Attestation should be done by class one officer in government/semi government organization orprofessionals, like C.A., ICWA, Gazzetted Officer, Notary, Actuary, Bank Manager, National InsuranceAcademy (NIA) Director etc. Professionals should mention their Institutes Membership number and affixtheir stamp. Attestation done by relatives is not valid.

Section: 4Method of Payment

DD / Pay Order No. : ___________________ Dated : _____________

Drawn on : ___________________________ Amount : _________________


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Section 5: - Declaration to be Signed by Applicant

I apply for admission as a Student Member of Institute of Actuaries of India. If my application isapproved I agree to confirm to the Rules and Professional Conduct Standards of the Institute as theycurrently exist or as they may in future be altered, amended or enlarged, and I will promote theobjectives of the Institute to the best of my ability. I understand that to withdraw from membership Imust inform the Institute of my resignation and that after payment of any arrears, return of books,

papers or other property of the Institute, I will be free from these obligations. I further declare that Ihave not applied earlier to the Institute for admission as a member. Note : In case the applicant hasearlier applied for admission as a member, the details of same should be furnished including

whether such admission was granted or denied.

Name (BLOCK LETTERS)

Signature .

Date . Place

Before signing this declaration you are advised to read the Rules & Regulations of the Institute,which is available on our Website,www.actuariesindia.org. Hard copies are available at IAI Office.

Section: 6 - Checklist

Please complete and assign the following.

a)b)

Please sign within box with black ink.

Signed:

Date: ________________________________

I have enclosed: certified copies of all educational / professionalcertificate (with English as one of the subjects)

Proof of Date of Birth

Enclosed the DD / Pay Order towards payment ofAdmission fees.

Signed and dated the applicants declaration.
http://www.actuariesindia.org/http://www.actuariesindia.org/http://www.actuariesindia.org/http://www.actuariesindia.org/


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FOR OFFICE USE ONLY

Receipt No. : Date:

Amount : _____________________________________

Date of Admission : _____________________________________

Membership No. : _____________________________________

Initial : _____________________________________