Notes to applicant

1. 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.

2. Please read the exemption assessment criteria and the PE syllabuses before applying for exemption(s).3. A non-refundable assessment fee of S$150 is required.4. You may submit any other documents relevant to this application. 5. 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: Pathways Development and Qualifications Department – ISCA PE60 Cecil Street, ISCA House, Singapore 049709

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 Core Subjects Required for Exemption

Code of Subjects

Name of Subjects Passed(At least 50% Pass Rate)

Exempted (Yes/No)Year of Exemption

For Official Use

Eg

Financial Management

Financial Accounting AA101 Principles of Accounting Yes (2008)  Finance AA201 Financial Analysis No

1 Business & Finance

Financial Accounting        Finance        Economics        Management & Strategy        Statistics        Information Management & Technology        

2 Management Information Management Accounting        

3 Financial Management

Financial Accounting        Finance        

FOR OFFICIAL USE

Exemption(s) granted: Business & Finance Management Information Financial Management

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Tel: +65 6597 5610| Email: profexam@isca.org.sg | Webpage: pe.isca.org.sg

ISCA Address: 60 Cecil Street, ISCA House, Singapore 049709

EXEMPTION ASSESSMENT APPLICATION FORM

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: Business & Finance Management Information Financial Management

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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.

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