2. PERSONAL DETAILS (Please include a certified copy of ...



03251201. PRACTISING CERTIFICATION REQUIREMENTS001. PRACTISING CERTIFICATION REQUIREMENTS635231140The EACTP recommends and encourages its members to hold a Practising Certificate designated for the conduct of Turnaround Management Practice in one or a number of recognised jurisdictions. This includes work you do in person or indirectly, regardless of whether you call yourself a Turnaround Professional, or charge a fee. You must also continue to comply with the EACTP qualifying conditions.Initial ApplicationAssociate and Member applicants must complete this form and include the initial Practising Certificate application fee. Applications must also be accompanied by evidence of:Practising in Turnaround Management and RestructuringConducting continuing professional development (CPD)On meeting the qualifying condition for the initial issue of a Practising Certificate, it will remain valid for a period of one year from the date of its original issue. It will be subject to revalidation each year.RevalidationYou are required to revalidate your Practising Certificate on an annual basis in writing by completing this form. In order to revalidate your Practising Certificate you must:Pay the annual revalidation feeComply with the Fundamental Principles set out in the Code of Ethics covering professional competence and due careMaintain competence in the Turnaround Management services you provideComply with the EACTP’s continuing professional development (CPD) requirements00The EACTP recommends and encourages its members to hold a Practising Certificate designated for the conduct of Turnaround Management Practice in one or a number of recognised jurisdictions. This includes work you do in person or indirectly, regardless of whether you call yourself a Turnaround Professional, or charge a fee. You must also continue to comply with the EACTP qualifying conditions.Initial ApplicationAssociate and Member applicants must complete this form and include the initial Practising Certificate application fee. Applications must also be accompanied by evidence of:Practising in Turnaround Management and RestructuringConducting continuing professional development (CPD)On meeting the qualifying condition for the initial issue of a Practising Certificate, it will remain valid for a period of one year from the date of its original issue. It will be subject to revalidation each year.RevalidationYou are required to revalidate your Practising Certificate on an annual basis in writing by completing this form. In order to revalidate your Practising Certificate you must:Pay the annual revalidation feeComply with the Fundamental Principles set out in the Code of Ethics covering professional competence and due careMaintain competence in the Turnaround Management services you provideComply with the EACTP’s continuing professional development (CPD) requirements-101604382135Surname ……………………………………………. ………………………..Forename(s)………………………………………………… Title…………...Date of birth (dd/mm/yyyy)………………….…….. Nationality………………………………………………………………….…Company………………………………………….................................……………………………………………………………………..Position / title………………………………………………………………………………………………………………..……….…………Address ……………………………………………………………………………. ………………………………………………………City……………………………………..……….……. County/Region ………………………………………………Postcode……………………….……….…………….. Country ……………………………………………………………Business tel…………………………………………… Mobile tel ……………………………………………… …………Email address……………………………………………………………………..Address for correspondence (if different from above) ……………………………………………………………………….……………...City……………………………………..……….……. County/Region ………………………………………………Postcode……………………….……….…………….. Country ……………………………………………………………Passport no (for ID purposes)……………………………………… Preferred contact method………………………………………...00Surname ……………………………………………. ………………………..Forename(s)………………………………………………… Title…………...Date of birth (dd/mm/yyyy)………………….…….. Nationality………………………………………………………………….…Company………………………………………….................................……………………………………………………………………..Position / title………………………………………………………………………………………………………………..……….…………Address ……………………………………………………………………………. ………………………………………………………City……………………………………..……….……. County/Region ………………………………………………Postcode……………………….……….…………….. Country ……………………………………………………………Business tel…………………………………………… Mobile tel ……………………………………………… …………Email address……………………………………………………………………..Address for correspondence (if different from above) ……………………………………………………………………….……………...City……………………………………..……….……. County/Region ………………………………………………Postcode……………………….……….…………….. Country ……………………………………………………………Passport no (for ID purposes)……………………………………… Preferred contact method………………………………………...-2032039497002. PERSONAL DETAILS (Please include a certified copy of your passport and a recent utility bill)002. PERSONAL DETAILS (Please include a certified copy of your passport and a recent utility bill)81915789940All applications for a Practising Certificate must specify the jurisdictions to which the Practising Certificate is to be designated. You can be awarded a Europe-wide Practising certificate, if you present significant supporting evidence for turnaround experience in three different jurisdictions and if you are a Member of EACTP. You need to present one case study in each of the three European countries/jurisdictions.The Practising Certificate jurisdictional designation application must be supported by evidence of:A pass in the Insolvency and relevant corporate and employment law module designated for the recognised jurisdiction, andThe experience requirements for membership appropriate for the recognised jurisdiction designation. 00All applications for a Practising Certificate must specify the jurisdictions to which the Practising Certificate is to be designated. You can be awarded a Europe-wide Practising certificate, if you present significant supporting evidence for turnaround experience in three different jurisdictions and if you are a Member of EACTP. You need to present one case study in each of the three European countries/jurisdictions.The Practising Certificate jurisdictional designation application must be supported by evidence of:A pass in the Insolvency and relevant corporate and employment law module designated for the recognised jurisdiction, andThe experience requirements for membership appropriate for the recognised jurisdiction designation. 819152930525Please select the jurisdiction/s that the certificate will be designated:??Europe-wide??Czech Republic??Italy ??Finland ??Netherlands ??Spain??Sweden ??Germany??France ??Ireland??Romania??United Kingdom??Other (please confirm)…………………………………………………………………………………………………………………..00Please select the jurisdiction/s that the certificate will be designated:??Europe-wide??Czech Republic??Italy ??Finland ??Netherlands ??Spain??Sweden ??Germany??France ??Ireland??Romania??United Kingdom??Other (please confirm)…………………………………………………………………………………………………………………..819152984503. RECOGNISED JURISDICTIONS 003. RECOGNISED JURISDICTIONS Please note: You do NOT have to complete Sections 4 and 5 if you have become a member of the EACTP within the last six 02291080Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………00Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………01376680Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………00Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………04119880Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………00Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………03205480Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………00Start date……………………….. End date…………………….. Country / jurisdiction…………………………………………….. Company…………………………………………..…………………………………………………………………………………………….City………………………………………………………….. Position / title………………………………………………………………06858004. TURNAROUND ASSIGNMENTS UNDERTAKEN004. TURNAROUND ASSIGNMENTS UNDERTAKEN0914400Details of Turnaround positions held in the last 12 months prior to application. 00Details of Turnaround positions held in the last 12 months prior to application. months.6354500880Case Study 3: Company / organisation………………………..……………………………………………………………………………Country / jurisdiction……………………………………… Dates of engagement (dd/mm/yyyy) from…………… to………………..Brief summary of role………………………..………………………………………………………………………………………………….………………………..…………………………………………………………………………………………………………………………..Referee:Name…………………………………………………………. Position / title……………………………………………………………Company ………………………………………………………. Country …………………………………………………………………Telephone…………………………………………………… Email……………………………………………………………………...00Case Study 3: Company / organisation………………………..……………………………………………………………………………Country / jurisdiction……………………………………… Dates of engagement (dd/mm/yyyy) from…………… to………………..Brief summary of role………………………..………………………………………………………………………………………………….………………………..…………………………………………………………………………………………………………………………..Referee:Name…………………………………………………………. Position / title……………………………………………………………Company ………………………………………………………. Country …………………………………………………………………Telephone…………………………………………………… Email……………………………………………………………………...6352797175Case Study 2: Company / organisation………………………..……………………………………………………………………………Country / jurisdiction……………………………………… Dates of engagement (dd/mm/yyyy) from…………… to………………..Brief summary of role………………………..………………………………………………………………………………………………….………………………..…………………………………………………………………………………………………………………………..Referee:Name…………………………………………………………. Position / title……………………………………………………………Company ………………………………………………………. Country …………………………………………………………………Telephone…………………………………………………… Email……………………………………………………………………...00Case Study 2: Company / organisation………………………..……………………………………………………………………………Country / jurisdiction……………………………………… Dates of engagement (dd/mm/yyyy) from…………… to………………..Brief summary of role………………………..………………………………………………………………………………………………….………………………..…………………………………………………………………………………………………………………………..Referee:Name…………………………………………………………. Position / title……………………………………………………………Company ………………………………………………………. Country …………………………………………………………………Telephone…………………………………………………… Email……………………………………………………………………...01089660Case Study 1: Company / organisation………………………..……………………………………………………………………………Country / jurisdiction……………………………………… Dates of engagement (dd/mm/yyyy) from…………… to………………..Brief summary of role………………………..………………………………………………………………………………………………….………………………..…………………………………………………………………………………………………………………………..Referee:Name…………………………………………………………. Position / title……………………………………………………………Company ………………………………………………………. Country …………………………………………………………………Telephone…………………………………………………… Email……………………………………………………………………...00Case Study 1: Company / organisation………………………..……………………………………………………………………………Country / jurisdiction……………………………………… Dates of engagement (dd/mm/yyyy) from…………… to………………..Brief summary of role………………………..………………………………………………………………………………………………….………………………..…………………………………………………………………………………………………………………………..Referee:Name…………………………………………………………. Position / title……………………………………………………………Company ………………………………………………………. Country …………………………………………………………………Telephone…………………………………………………… Email……………………………………………………………………...635-4445Please provide details of turnaround cases in which you are able to demonstrate significant influence over the outcome. Please present an overview of each turnaround case using the template form on our website (). The cases should be specific to the jurisdiction for which you applying for a Practising Certificate. Each case study should be counter-signed by a Referee. 00Please provide details of turnaround cases in which you are able to demonstrate significant influence over the outcome. Please present an overview of each turnaround case using the template form on our website (). The cases should be specific to the jurisdiction for which you applying for a Practising Certificate. Each case study should be counter-signed by a Referee. 0-3302005. CASE HISTORY & SUPPORTING EVIDENCE005. CASE HISTORY & SUPPORTING EVIDENCE-5651519056. CERTIFICATE TYPE & PAYMENT006. CERTIFICATE TYPE & PAYMENT-6485890421005What type of certificate are you applying for?AssociateMemberAPPLICATION FEE???50/€60???75/€90ANNUAL FEE???25/€30???50/€60Billing of Fees All applications must be accompanied by payment for the initial application fee before being considered. Fees run on a calendar year basis. Annual membership in the first year is billed on a pro-rata monthly basis from the date the application is accepted to 31 December of that year, and thereafter annually on 1 January. Refunds If your application is not successful, your application fee will be refunded subject to a ?75.00 administration fee. Invoicing You will be informed when your application is ready for processing and you will be invited to make a payment. A VAT invoice will be sent to you. VAT All fees are exempt for VAT. Currency Fees can be paid in any European currency.00What type of certificate are you applying for?AssociateMemberAPPLICATION FEE???50/€60???75/€90ANNUAL FEE???25/€30???50/€60Billing of Fees All applications must be accompanied by payment for the initial application fee before being considered. Fees run on a calendar year basis. Annual membership in the first year is billed on a pro-rata monthly basis from the date the application is accepted to 31 December of that year, and thereafter annually on 1 January. Refunds If your application is not successful, your application fee will be refunded subject to a ?75.00 administration fee. Invoicing You will be informed when your application is ready for processing and you will be invited to make a payment. A VAT invoice will be sent to you. VAT All fees are exempt for VAT. Currency Fees can be paid in any European currency.-64858903192780Payment Methods00Payment Methods-64858903469005??Cheque (made payable to EACTP) ??Bank Transfer Beneficiary: EACTP, Bank: AIB GB, SWIFT code: AIBKGB2L Sort code: 23-84-83Account number only for domestic bank transfers: 01662 032Account number only for international bank transfers (IBAN): GB56 AIBK 2384 8301 6620 32??Credit Card (please complete and sign below, alternatively you can call us to provide your details over the phone) Type of Card ………………………………………… Card number……………………………………………………………………. Exp. date (mm/yy)………………………… Security code (last three digits on back of card) …………………………Name (as it appears on card)…………………………………………………………………………….………………………………Full postal address of card holder (if different from Section 2) …………………………………………………………….………City……………………………………..……….……. County/Region ………………………………………………….Postcode……………………….……….…………….. Country ……………………………………………………………I hereby authorise you to deduct the total amount above from the card number shown:Signature…………………………………………………………………………………………………… Date…………………………. 00??Cheque (made payable to EACTP) ??Bank Transfer Beneficiary: EACTP, Bank: AIB GB, SWIFT code: AIBKGB2L Sort code: 23-84-83Account number only for domestic bank transfers: 01662 032Account number only for international bank transfers (IBAN): GB56 AIBK 2384 8301 6620 32??Credit Card (please complete and sign below, alternatively you can call us to provide your details over the phone) Type of Card ………………………………………… Card number……………………………………………………………………. Exp. date (mm/yy)………………………… Security code (last three digits on back of card) …………………………Name (as it appears on card)…………………………………………………………………………….………………………………Full postal address of card holder (if different from Section 2) …………………………………………………………….………City……………………………………..……….……. County/Region ………………………………………………….Postcode……………………….……….…………….. Country ……………………………………………………………I hereby authorise you to deduct the total amount above from the card number shown:Signature…………………………………………………………………………………………………… Date…………………………. -648589067932307. CONTINUING PROFESSIONAL DEVELOPMENT (CPD)007. CONTINUING PROFESSIONAL DEVELOPMENT (CPD)-64858907050405Minimum Annual Requirements Non-practising members are required to complete a minimum of five hours of structured CPD training per annum or alternatively 15 hours of unstructured CPD training per annum.Members holding a Practising Certificate are required to complete a minimum of 15 hours of structured CPD training per annum or alternatively 35 hours of unstructured CPD training per annum.Structured CPD TrainingStructured CPD training required to comply with members minimum CPD requirements can only be provided by organisations approved by the EACTP for this purpose.Annual DeclarationMembers are required to provide an annual declaration that they have complied with the minimum CPD requirements appropriate to their personal circumstances. Evidence will be required to be provided to support any renewal of a Practising Certificate or on request by the SAC.00Minimum Annual Requirements Non-practising members are required to complete a minimum of five hours of structured CPD training per annum or alternatively 15 hours of unstructured CPD training per annum.Members holding a Practising Certificate are required to complete a minimum of 15 hours of structured CPD training per annum or alternatively 35 hours of unstructured CPD training per annum.Structured CPD TrainingStructured CPD training required to comply with members minimum CPD requirements can only be provided by organisations approved by the EACTP for this purpose.Annual DeclarationMembers are required to provide an annual declaration that they have complied with the minimum CPD requirements appropriate to their personal circumstances. Evidence will be required to be provided to support any renewal of a Practising Certificate or on request by the SAC.6354516755Before you send your application, please check you have included all supporting documentation required for your application:Member TypeDocuments requiredALL APPLICANTS??Completed and signed the Practising Certificate form??Certified copy of your passport and recent utility bill??Payment or payment detailsASSOCIATE??One case study *MEMBER??Three case studies *EUROPE-WIDECERTIFICATE??One case study for three different countries/jurisdictions.*You do NOT need to supply case studies if you have become a member of the EACTP within the last 6 months.FURTHER INFORMATIONProcessing of application: Your application will be reviewed by the EACTP Secretariat and if complete with all of the above required documents, it will be passed on to the Standards and Admissions Committee to be determined.Confidentiality: All submissions are restricted to EACTP Directors and SAC members who are limited by confidentiality agreement from divulging or in any way using submitted information which is not in the public domain, in a personal or professional capacity without the express permission of the applicant.?Your details: By submitting this form you agree to the EACTP retaining your details and to receive furtherinformation regarding EACTP and its services. If you would like to be excluded, please email secretariat@eactp.euSubmission of applications and contacts: Once complete, please PRINT this form and send via post or email to the address below. For queries contact EACTP secretariat via AddressEACTP, c/o PKF Cooper Parry, Sky View, Argosy Road, East Midlands AirportCastle Donington, Derby DE74 2SA, United Kingdom Email secretariat@eactp.eu Telephone +44 (0)208 2863025 Telephone +44 (0)7970 17560600Before you send your application, please check you have included all supporting documentation required for your application:Member TypeDocuments requiredALL APPLICANTS??Completed and signed the Practising Certificate form??Certified copy of your passport and recent utility bill??Payment or payment detailsASSOCIATE??One case study *MEMBER??Three case studies *EUROPE-WIDECERTIFICATE??One case study for three different countries/jurisdictions.*You do NOT need to supply case studies if you have become a member of the EACTP within the last 6 months.FURTHER INFORMATIONProcessing of application: Your application will be reviewed by the EACTP Secretariat and if complete with all of the above required documents, it will be passed on to the Standards and Admissions Committee to be determined.Confidentiality: All submissions are restricted to EACTP Directors and SAC members who are limited by confidentiality agreement from divulging or in any way using submitted information which is not in the public domain, in a personal or professional capacity without the express permission of the applicant.?Your details: By submitting this form you agree to the EACTP retaining your details and to receive furtherinformation regarding EACTP and its services. If you would like to be excluded, please email secretariat@eactp.euSubmission of applications and contacts: Once complete, please PRINT this form and send via post or email to the address below. For queries contact EACTP secretariat via AddressEACTP, c/o PKF Cooper Parry, Sky View, Argosy Road, East Midlands AirportCastle Donington, Derby DE74 2SA, United Kingdom Email secretariat@eactp.eu Telephone +44 (0)208 2863025 Telephone +44 (0)7970 17560663542500559. CHECKLIST:009. CHECKLIST:0-361958. DECLARATION008. DECLARATION0220980I hereby apply for membership as a Certified Turnaround Professional and understand that my application depends on my ability to meet all requirements and qualifications and is subject to approval by the Standards and Admissions Committee (SAC). I certify that the information contained in this application is true and correct. I further understand that if any information is later determined to be false, EACTP reserves the right to revoke any certification that has been granted on the basis thereof.Indicate your understanding of, and agreement to comply with, the following by checking the boxes that precede each statement:In making and filing this application for membership, I authorise all persons, firms and entities to furnish any relevant information that may be requested by the EACTP in connection with the investigation of this application.I release and indemnify the EACTP and its Board of Directors, officers and employees from any and all liability arising from the investigation and evaluation of this application, decisions relative to the granting of certification, continuing professional education requirements and standards of practice.I acknowledge that all other sections, paragraphs and parts of this application are incorporated herein without specific reference.I have received, read and agree to comply with the EACTP Code of Ethics I agree to abide by the certification conditions of the EACTP programme.I am not under any criminal investigation by any government or regulatory authority, nor any other investigation or proceeding pending with any professional or certification entity. I understand if I am, I must fully disclose this and all details on a separate document.By providing my handwritten signature dated below, I indicate my understanding of and agreement to comply with the terms of this application.Signature…………………………………………………………………………………… Date………………………………………00I hereby apply for membership as a Certified Turnaround Professional and understand that my application depends on my ability to meet all requirements and qualifications and is subject to approval by the Standards and Admissions Committee (SAC). I certify that the information contained in this application is true and correct. I further understand that if any information is later determined to be false, EACTP reserves the right to revoke any certification that has been granted on the basis thereof.Indicate your understanding of, and agreement to comply with, the following by checking the boxes that precede each statement:In making and filing this application for membership, I authorise all persons, firms and entities to furnish any relevant information that may be requested by the EACTP in connection with the investigation of this application.I release and indemnify the EACTP and its Board of Directors, officers and employees from any and all liability arising from the investigation and evaluation of this application, decisions relative to the granting of certification, continuing professional education requirements and standards of practice.I acknowledge that all other sections, paragraphs and parts of this application are incorporated herein without specific reference.I have received, read and agree to comply with the EACTP Code of Ethics I agree to abide by the certification conditions of the EACTP programme.I am not under any criminal investigation by any government or regulatory authority, nor any other investigation or proceeding pending with any professional or certification entity. I understand if I am, I must fully disclose this and all details on a separate document.By providing my handwritten signature dated below, I indicate my understanding of and agreement to comply with the terms of this application.Signature…………………………………………………………………………………… Date……………………………………… ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download