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    SOCIETY OF TECHNICAL ANALYSTS PHILIPPINES

    CTA Membership Application

    PERSONAL DATA

    Mr./Ms./Mrs./Miss/Dr. *

    Surname *

    First Name *

    Middle Name *

    Suffix

    Date of Birth: *

    Gender *

    CONTACT INFORMATION

    HOME MAILING ADDRESS

    Home / Bldg. No.*

    Bldg. Name / Street / Road / Subdivision*

    Barangay*

    City *

    Province / Region *

    Postal Code *

    Landline Number

    Mobile Number *

    Personal E-mail Address *

    BUSINESS MAILING ADDRESS

    Position

    Company Name

    Unit / Bldg. No.

    Bldg. Name / Street / Road / Subdivision

    Barangay

    City

    Province

    Postal Code

    Phone Number

    Fax Number

    E-mail Address

    EDUCATION & PROFESSIONAL INFORMATION

    BACHELOR’S DEGREE

    Course

    University

    Year

    MASTERAL

    Course

    University

    Year

    DOCTORAL

    Course

    University

    Year

    OTHER

    Course

    University

    Year

    FEES

    Certification Package

    Php 5,000

    Via courier with additional fee of P300

    Php 300

    TOTAL FEE

    Php 5,300

    Preferred mailing address: *

    PROOF OF PAYMENT

    Make sure to upload *Scanned Copy or Screenshot of your VALIDATED Proof of Payment with transaction details such as Date of Transaction, Payment Reference no., Amount Paid, Bank Account no. (should be visible)

    *Upload your file here (File name must be: Surname_FirstName):

    DATA PRIVACY

    Upon signing this form you are agreeing that the personal data obtained from the registration form entered and stored within the Institute’s authorized information and communications system and will only be accessed by the STA authorized personnel. Furthermore, the information collected and stored in this form shall only be used for the following purposes:

    • Announcements / promotions of events, programs, courses and other activitiesoffered / organized by the Institute and its partners;

    • Activities pertaining to establishing relations with participants/members/alumni;

    • STA Philippines has the right to share your information to our related affiliate companies, institutions, and or subsidiaries;

    • STA Philippines shall not disclose the participants/members/alumni personal information without their consent and shall retain this information over a period of ten years for effective implementation, research analytics, and management.

    ACCEPTANCE OF SUBSCRIPTION

    I declare that all of the information contained in this application is true and correct and I agree to provide any supporting documentation requested by the Institute. If accepted, I agree to abide by the Society of Technical Analysts’ Code of Professional Conduct and Continuing Professional Education requirements. I understand that I must renew my subscription annually to enjoy the services provided by the Institute including eligibility privileges and retention of professional designation.

    Digital Signature *

    Date Signed *

    Please double check your PERSONAL EMAIL if entered correctly before submitting the form.
    Confirmation email will be sent there.