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 namesGiven nameGender*MaleFemaleAddress*Zip code*City*TelephoneMobile telephonePersonal 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 obligation yourself to the payment of the 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 full tuition fee is due before the 1st of February 2019. The program will start if sufficient (10) enrollments have been received. In case of cancellation you are obligated to pay the cancellation fee of €500,- (excl. 21% VAT). Cancellation is only possible before the start of the program. 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.