Tel: +65 6704 9800| Email: profexam@isca.org.sg | Webpage: pe.isca.org.sg ISCA Address: 111 Somerset Road, #07-05, TripleOne Somerset Singapore 238164 EXEMPTION ASSESSMENT APPLICATION FORM Notes to applicant 1. 2. 3. 4. 5. This assessment form is to be completed by applicant wishing to apply for exemption based on prior course of studies and/or based on relevant working experience of at least 5 years. Please read the exemption assessment criteria and the PE syllabuses before applying for exemption(s). A non-refundable assessment fee of S$150 is required. You may submit any other documents relevant to this application. Please complete this form electronically and upload the completed form during the submission of PE application. Alternatively, please submit the completed form and the supporting documents to the following address: Examinations and Qualification Department 111 Somerset Road, #07-05, TripleOne Somerset Singapore 238164 SECTION A Applicant’s Personal Information Name of applicant: NRIC no: I wish to apply for module exemption(s) based on: [tick (√) more than one, if applicable] Prior course of studies - Please complete Section B below Working experience (minimum 5 years in related field) - Please complete Section C below SECTION B - Prior Course of Studies (To be completed if you wish to apply for exemption based on prior course of studies) Please indicate all the relevant subjects attempted with at least a 50% pass mark, next to any of the core subjects listed below: Subjects may be repeated if it covered more than one core subject area. Indicate at the beginning of each subject the code and name of subject eg. Eg AC201 Financial Analysis, AC101 Principles of Accounting, AC301 Accounting Theory. Exempted subjects must be indicated with a "Yes" under the Exempted column with the year exemption was granted. ISCA PE Modules Eg Financial Management Core Subjects Required for Exemption Code of Subjects Name of Subjects Passed (At least 50% Pass Rate) Exempted (Yes/No) Year of Exemption Financial Accounting AA101 Principles of Accounting Yes (2008) Finance AA201 Financial Analysis No For Official Use Financial Accounting Finance 1 Business & Finance Economics Management & Strategy Statistics Information Management & Technology 2 Management Information 3 Financial Management Management Accounting Financial Accounting Finance FOR OFFICIAL USE Exemption(s) granted: Page 1 of 3 Business & Finance Management Information Financial Management SECTION C – Working Experience (To be completed if you wish to apply for exemption based on relevant working experience) Part I: Competencies gained at Workplace Please provide descriptions of key work place competencies and examples of relevant evidence that would indicate proficiency for each of the PE module. Syllabuses of PE Module* Description of competencies achieved through relevant work experience For Official Use Competencies achieved through relevant work experience Further comments, if any [eg: a reflective statement to demonstrate the competency development achieved through relevant work experience which fulfil 75% of the relevant PE module syllabus] (*Use a separate copy of this template for each PE module. Please refer to ISCA website for the relevant PE module syllabuses) Part II: Third Party Verification Please provide testimonials from two referees who can attest your relevant experience. Such verification must be made in a separate currently dated letter or document appearing on the employer’s letterhead. Please also provide the following information of the referees: Referee 1 Referee 2 Name : Name : Company : Company : Title(s) of position(s) held : Title(s) of position(s) held : Contact no : Contact no : Email address : Email address : This is the criteria for referee for the purpose of attestation of working experience: Present or former employer, preferably a current CA Singapore of ISCA or a full member of an accountancy body recognized by ISCA, who is either A supervisor / superior or A HR personnel with appropriate responsibilities FOR OFFICIAL USE Exemption(s) granted: Page 2 of 3 Business & Finance Management Information Financial Management CHECKLIST Please remember to submit certified true copies of the following documents: NRIC (for Singaporeans & PRs) / Passport (for foreigners) Degree scroll Degree transcript(s) Course outlines Grading scheme (for the results reflected in the transcript(s)) Employers’ testimonials, if any Other relevant academic (e.g. Diploma) and/or professional accounting related qualifications *Documents are to be certified as true copy by either: - (1) the Institution(s) awarding the academic certificates; (2) an Advocate and Solicitor; or (3) a Chartered Accountant of Singapore (CA Singapore). Note: Application without relevant documents attached will not be processed. All documents submitted must be in English, otherwise an official English translation to be provided. Please attach all relevant documents before submission. Please arrange your documents in the following order as shown below. Thank you. Page 3 of 3