Visa Master American Express Card No HKSI

					                                                     INVESTMENT ADMINISTRATION QUALIFICATION (IAQTM)

Registration Form
Please read the terms & conditions overleaf before completing the registration form.

Part A: Personal Particulars
 Name In English:                                                                              /          /
 Title: (Mr/Mrs/Miss/Ms)           Surname                  Given Name                   Date of Birth(dd/mm/yy)               Candidate Number (if applicable)
 HKID / Passport No.:                                                                   (For examination purpose only)
 Correspondence Address:

 Office Tel No:                                                                                 Home Tel No:
 Fax No:                                                                                        Mobile:
 E-mail :                                                                              (This field is mandatory)
 Name of Company                                                    Name of Department                      Position Held
 ______________________________________                             _______________________________         _______________________________
 Education Qualifications:
 Postgraduate or above          □University                   □              Tertiary     □              Secondary       □
Part B: Examination Booking
                 Examination Unit                           Fee                                      Examination Date*
                                                          (HKD)                     1st Choice                             2nd Choice
                                                                         Date (dd/mm/yy) & Session (am/pm)      Date (dd/mm/yy) & Session (am/pm)
 International Introduction to Securities &
 I.T. in Investment Operations                             2,625
 Asset Servicing (Corporate Actions)                       2,625
 Exchange-Traded Derivatives Administration                2,625
 Global Securities Operations                              2,625
 Operational Risk                                          2,625
 Over-The-Counter Derivatives Administration               2,625
 Principles of Financial Regulation unit                   3,000
 Risk in Financial Services                                3,500
 Note – A) three IAQ units are required to achieve the full IAQ or B) an Exemption** and two further IAQ units are required to achieve the IAQ (Hong Kong) or IAQ (China)
* Note – CISI’s examination booking system is ‘real-time’ so whilst we try to accommodate candidates’ preferred dates and times these
cannot be guaranteed until booking is confirmed.
** Note – Please refer IAQTM Exemption Request Form for Recognized Exemption

Part C: Payment (Non-refundable)
  Total Amount of HK$                               is paid by: (The fees are subject to revision without notice)
  □ Cash                □
  □  Personal Cheque (Cheque No. : ___________________        Date: ____________________ )
  □  Company Cheque (Cheque No. : ______________________           Date : ____________________ )
     (Made cheque payable to “Hong Kong Securities and Investment Institute”)
  □  Visa Card           □
                       Master Card                  □
                                             American Express Card (Please note the Institute does not accept Diners cards)

  Visa / Master / American Express Card No. :         □□□□□□□□□□□□□□□□
  Name of Cardholder: _____________________ Expiry Date: _____________________ (MM/YY)
  (CARD HOLDER MUST BE THE CANDIDATE; Otherwise HKSI will reject the application.)

  Signed: _____________________                               Date: _____________________
  (This signature must correspond with the signature on the credit card.)

Part D: For Office Use Only
Examination Schedule Date : _____________________                             Status      : Accept/Rejected/Waiting              Date        : ________________

Prior to booking and paying for an examination, candidates are required to read the policies on exam bookings

1. Candidates will receive the following within 10 working days from receipt of Candidate Registration Form:

a) a Candidate Registration Acknowledgment Email
b) a hardcopy of the Workbook, provided one has been published for the qualification in question
c) an Examination Confirmation Email
d) an eLearning Order Confirmation Email, provided one has been published for the qualification in question

2. Registration will only be confirmed upon receipt of payment. Any registration forms without appropriate payments will be rejected. Application
indicating payment by cheque will not be processed without attachment of a cheque.

3. Refund is not considered.

4. Please note examination dates cannot be guaranteed as bookings are subject to availability.

5. Prices indicated are effective from January 2009 and subject to revision.

6. Study materials such as the workbook and eLearning tools are subject to expiry. Upon expiry, it can be re-purchased at the full cost.

7. HKSI & CISI does not bear any responsibility for cancellation or termination of examinations conducted at the test centre. However, candidates
will be provided with replacement of the next best alternative exam date(s) chosen by the candidate.

Applicant's Declaration
I hereby declare that the information I provided in this application form is complete and correct. I have read the terms and conditions above and
agree to abide by the terms and conditions mentioned.

Signature of Applicant: ______________________________                            Date: ______________________

                                                           How to Contact Us
Address: 24th Floor, Wing On Centre, 111 Connaught Road Central, Hong Kong
Tel: 3120 6200 Fax: 2899 2611 E-mail:
Opening Hours: 9:00am – 5:30pm (Mon- Fri)

Address: 8 Eastcheap, London, EC3M 1AE
Tel: +44 (0)20 7645 0680 Fax: +44 (0)20 7645 0601 E-mail:

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