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Candidate Membership Application Form
Candidate Membership Application Form
"
*
" indicates required fields
Please complete the form and click the Submit button at the end. Copies of the following documents need to be submitted along with the application form:
ID Document
CV
Qualifications
I hereby apply to become a candidate member of the Fiduciary Institute of Southern Africa (FISA).
Title
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Adv
Prof
Dr
Rev
Mr
Mrs
Ms
Other
If "Other" chosen above, please insert details here:
Surname
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Full Name(s)
*
SA ID Number
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Address
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Address Line 1
Address Line 2
City
Province / Region
Postal Code
Telephone (H)
Drop the ‘0’ e.g. +27 11 555 1234
Telephone (W)
Cellphone
Email Address
*
Current Employer
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Company Registration No. (only necessary if employer will pay fees)
Company VAT No. (only necessary if employer will pay fees)
PERSONAL EXPERIENCE (The minimum experience required in the fiduciary field is three years).
Current Position
*
From (Date)
*
DD slash MM slash YYYY
Describe your Responsibilities
*
Previous Position 1
Employer
From (Date)
MM slash DD slash YYYY
To (Date)
MM slash DD slash YYYY
Describe your Responsibilities
Previous Position 2
Employer
From (Date)
MM slash DD slash YYYY
To (Date)
MM slash DD slash YYYY
Did you pass Matric?
*
Yes
No
Please list all your tertiary qualifications
Where did you hear about FISA?
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Media
Social Media
Internet
Colleague
Friend
Other
If "Other" chosen above, please insert the details here:
QUESTIONS: Please answer all the questions below by clicking YES or NO. IMPORTANT:
If you answer yes to any of the questions, please supply full details in writing and send it to FISA along with your other documentation requested at the top of this form. Quote the number of the relevant question when supplying the details.
Question 1 – Have you been declared mentally incapacitated or otherwise incapable of managing your own affairs?
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Yes
No
Question 2 – Have you been removed (in your personal capacity or as a nominee of a corporation) by a competent court from the position of executor of an Estate, in accordance with the provisions of section 54(1)(a)(ii), (iii), or (iv) of the Administration of Estates Act, 66 of 1965 (the “Estates Act”)?
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Yes
No
Question 3 – Have you been declared incapable, by a competent court, of holding the office of executor, in accordance with the provisions of section 54(4) of the Estates Act?
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Yes
No
Question 4 – Have you been removed (in your personal capacity or as a nominee of a corporation) from the position of executor of an estate by a competent court in accordance with the provisions of section 54(1)(a)(v), or by the Master of the High Court in accordance with the provisions of section 54(1)(b)(ii), (iii), (iv), or (v) of the Estates Act?
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Yes
No
Question 5 – Are you the subject of any disciplinary or appeal panel hearing, constituted in accordance with the provisions of the Disciplinary Regulations of FISA?
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Yes
No
Question 6 – Have you been sequestrated, provisionally or finally, or surrendered your estate for the benefit of your creditors, or have you made an offer of compromise to your creditors in circumstances where your liabilities exceeded your assets?
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Yes
No
Question 7 – Have you had a civil judgement, for the recovery of an unpaid debt, given against you?
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Yes
No
Question 8 – Have you had a civil judgement given against you for any act or omission containing an element of dishonesty or misrepresentation on your part?
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Yes
No
Question 9 – Have you been declared by a competent court to be over-indebted, or have you applied to be placed under debt review under the provisions of the National Credit Act, 34 of 2005, or any substituting or similar legislation.
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Yes
No
Question 10 – Have you (in your personal capacity or as a nominee of a corporation) been disqualified from being authorised as a trustee under the provisions of section 6(1A) of the Trust Property Control Act, 57 of 1988 (the Act), or have you been removed as trustee by a competent court or by the Master of the High Court, in accordance with the provisions of section 20 of the Act?
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Yes
No
Question 11 – Have you been convicted by a court of criminal justice in the Republic (or anywhere in the world) of any criminal offence of which dishonesty is an element, or which is listed in the First Schedule to the Criminal Procedure Act, 51 of 1977 as amended (or an equivalent offence anywhere in the world), and, in the case of a First Schedule offence (or its equivalent) of which dishonesty is not an element, been sentenced to imprisonment without the option of a fine?
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Yes
No
Question 12 – Are you under investigation for any criminal offence of which dishonesty is an element, or which is listed in the First Schedule to the Criminal Procedure Act, 51 of 1977 as amended (or its equivalent anywhere in the world)?
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Yes
No
Question 13 – Have you been found guilty in a disciplinary hearing by an employer, a regulator in any industry or another association, institute or other membership organisation of misconduct of which dishonesty is an element, or which corresponds with a crime listed in the First Schedule to the Criminal Procedure Act, 51 of 1977, as amended?
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Yes
No
Question 14 – Are you, your employer, or any business or partnership you are involved in, under investigation by any authority for conduct which may affect your fitness to be placed in a position of trust?
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Yes
No
Date
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MM slash DD slash YYYY
Please upload the REQUIRED DOCUMENTATION to attach with your application
CV
*
Max. file size: 10 MB.
ID Document
*
Max. file size: 10 MB.
Qualifications
*
Max. file size: 10 MB.
DECLARATION:
1. I understand that I am subject to the Code of Ethics and of Professional and Responsible Conduct of FISA, as well as the FISA Constitution and Regulations, and I undertake to comply with all provisions therein.
2. I undertake to comply with the Continuing Professional Development (“CPD”) requirements as determined from time to time.
3. I hereby give my consent to FISA to process my personal information in any necessary, fair and reasonable manner in the furtherance of the objectives as stated in clause 7 of the FISA
Constitution
.
4. I hereby agree that FISA may use my ID/passport number to verify my qualifications, obtain information about my creditworthiness, and ascertain whether I have a criminal record.
5. I declare that all information in this application is, to the best of my knowledge and belief, true and correct, and I hereby apply for FISA candidate membership for 2024.
Name
This field is for validation purposes and should be left unchanged.