Cost and Works Accountants Act, 1959
FORM I : APPLICATION FOR REGISTRATION AS A STUDENT
[See Regulation 20]
THE INSTITUTE OF COST AND WORKS ACCOUNTANTS OF INDIA
To
The Secretary to the Council of
The Institute of Cost and Works Accountants of India,
12, Sudder Street, Calcutta-16.
Sir,
I beg to apply for Registration as a Student of the Institute of
Cost and Works Accountants of India. The required particulars are furnished
below:
1. Name in full (in Block Letters)
2. Address
3. Age and date of birth13
4. Occupation in full.
5. Educational Qualifications14
6. Father's Name.
7. In case the applicant was previously admitted as a Registered
Student of the Institute or of the dissolved company, and if at any time such
Registration was cancelled, discontinued or otherwise terminated:-
(a) The date of previous Registration.
(b) The former Registration Number.
(c) The reasons for cancellation, discontinuance, etc.
II I hereby declare that the particulars furnished above are
true to the best of my knowledge and belief and should it at any time be proved
that the said particulars were untrue, I agree to my Registration being
cancelled without any obligation on the part of the Institute to refund any fee
or subscription paid by me to the Institute. I also hereby undertake that, if
enrolled as a Registered Student of the Institute, I will be bound by the
provisions of the Cost and Works Accountants Act, 1959, and the Regulations
framed thereunder or that may hereafter from time to time be made pursuant to
the said Act.
III I also send herewith a sum of 19[Rs. ............
] being the Student Registration Fee.
Place: Yours faithfully,
Date: Signature