CPA Ireland - Maternity Leave Application Form 2019

Maternity Leave Application Form 2019

Please note that reduced subscription rates are not available to Members who are in receipt of any employment or self employed income, regardless of the source.

If you wish to apply for CPD Exemptions for 2019 please contact Jenny Conmy at jconmy@cpaireland.ie .

Confirmation:	I acknowledge that any statement contained herein which is known to be false may invalidate this application and any decision reached thereon by the Council and/or Executive Staff of the Institute of Certified Public Accountants may lead to disciplinary action being taken against me.
Name:
CPA Membership number:
Address:
Phone number:
Email address:
Maternity Leave Dates:
Have you applied to enrol in CPA Ireland Skillnet Programme?:	Yes No
Confirmation:	I confirm that I am not in receipt of any income from any work related source
Confirmation:	I declare that the information contained in this application is true, accurate and complete to the best of my knowledge and belief
Confirmation:	I will notify the CPA Institute once I return to work or business, whether on a part time or full time basis.
Confirmation:	I understand that if approved, this application does not exempt me from my CPD requirements*, including that of making an annual CPD return.