I hereby certify that the information given by me in this Application for Membership is true and correct. I understand that any false information in this   Application lead to disqualification from applying for membership of the Society of Certified Management Accountants.
Signature of Applicant : .............................................................	Date : ............................................

(A).   Standard Industries Classifications (SIC)		(B).   Designation (D)		(C).   Responsibility Area (RA)
1. Agriculture, Fisheries & Plantation   2. Construction & Engineering   3. Transportation, Communication & Utility       Services   4. Banking, Finance & Insurance   5. Manufacturing   6. Wholesale & Retail Trade   7. Hotels & Travels   8. Services   9. Land & Property   10. Government   11. University & Educational Services   12. Others - specify		1. Chairman of the Board   2. Chief Executive Officer   3. Finance Director   4. Finance Manager   5. Director   6. General Manager   7. Chief Accountant   8. Accountant   9. Practicing Accountant   10. IT Manager   11. Finance Analyst   12. Professor / Lecturer   13. Consultant   14. Others - specify		1. General Management   2. Corporate Management   3. Public Accounting   4. General Accounting   5. Cost Accounting   6. Government Accounting   7. Finance / Treasury   8. Risk Management   9. Budgeting & Planning   10. Taxation   11. Internal Auditing   12. Information Systems   13. Education   14. Others - specify