Enrollment form CMA program 2019 – 2020 You can fill out the form below, or download the forms in Dutch or English. 1 Undersigned2 Employer3 Enrollment4 Invoicing5 Signing UndersignedName (surname)*First names*Given name*Gender*MaleFemaleAddress*Zip code*City*TelephoneMobile telephone*Personal email* Date of birth DD MM YYYY Country and city of birthHighest degree and University EmployerName of the organisationAddressZip codeCityTelephoneBusiness emailaddress Current position EnrollmentStudent wishes to enroll for:* Certified Management Accountant (CMA) Program offered by the Staan Academy Is this your first enrollment af Staan Academy?YesNoIn case of first time enrollment, please include: - a copy of a valid passport or ID card - a copy of your highest degree - a copy of your and gradelistUpload scan id or passportAccepted file types: jpg, gif, png, pdf.Maximum file size: 2 MB.Upload copy higest degreeAccepted file types: jpg, gif, png, pdf.Maximum file size: 2 MB.Upload copy gradelistAccepted file types: jpg, gif, png, pdf.Maximum file size: 2 MB.How did you hear about Staan AcademyGoogleNewsletterLinkedInTwitterFacebookColleagueAcquaintanceIMAPressSomeone of staanOtherPlease specifiy InvoicingThe invoice needs to be sent to**StudentEmployer *Student declares to fulfill all financial obligations and payments in accordance with payment terms of the Staan Academy* Authorization EmployerUndersigned agrees on behalf of the employer to pay te tuition according to the payments terms below to the Staan Academy (part of Staan Finance & Consultancy BV).NamePositionPlaceDate DD MM YYYY SignatureInvoice details employerName employerInvoice addressZip codeCityPlease select what is applicablecost centerpo numberCost center numberPO numberBusiness e-mailaddress for invoice Terms and undersigning Payment oblications Via enrollment you are obligating yourself (or your employer) to the payment of the full tuition of €3.250,- - (excl. 21% VAT). At enrollment €500,- (excl. 21% VAT) will be invoiced (for the remainder a seperate invoice will be sent). The program will start if sufficient enrollments have been received. Cancellation is only possible 2 weeks (or sooner) before the start of the course. In case of cancellation you are obligated to pay the cancellation fee of €500,- (excl. 21% VAT). Place*Date* DD MM YYYY Signature*PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.