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1、IIA membership number _ THE INSTITUTE OF INTERNAL AUDITORS, INC International Headquarters, 249 Maitland Avenue Altamonte Springs, Florida 32701, Phone: 305/830-7600 MEMBERSHIP APPLICATION Application may be submitted to IIA International Headquarters or to local chapter for processing Please Type o
2、r Print Clearly (if more space is necessary, attach separate statement) PERSONAL DATA.Mr. .Mrs. .Ms. .Other _Name. _ (Last) (First) (Middle)Home Address _ _City_State/Province _ Zip/Pin Code _Country _Home Phone (Include country & city code) _E-mail Address, if available _Mail to be sent to your ( )
3、 Home Address ( ) Business Address Name exactly as you want it to appear on membership certificate EDUCATIONGraduation Degree _ Year _Highest Degree _ Year _Professional Qualification, if any (Mention name of the Institute also)_ BUSINESS DATACompany _Address_City_ State/Province _Zip/Pin Code _ Cou
4、ntry _Business Phone (Mention country & city code) _Type of Business _Company Size by number of employees /Locations _Designation/Job Title_Nature of Responsibilities _Period Employed _ Years in present position _Are the auditing activities of your company under your jurisdiction? Yes ( ) Partly ( )
5、 No ( )Do you direct & supervise audits Yes ( ) Partly ( ) No ( )Number of Internal auditors on company staff _Specify fully the nature of your auditing duty _ REFERENCESTwo reference names are required. It is preferable that one of them be a member of The Institute of Internal Auditors,Inc. The sec
6、ond reference should be a business acquaintance. If you do not know a member of The Institute, give two business references. References not required for CIAs.1. Name _ Position _ Business Affiliation _ Address _ _City _ State/Province _ Zip/Pin Code _ Country_Telephone Office _ Residence _Member of IIA: Yes ( ) No ( )2. Name _ Position _ Business Af
