Please complete the below application if you are a first time Student at CAIRP. If you are currently a CQP Candidate or taking either IA or PCIC, please contact Benjamin Lecointre at Benjamin.Lecointre [AT] cairp.ca.
Salutation== select == Mr. Ms. Miss Mrs. M. Mme. Dr. Hon.
First Name
Middle Name/Initial
Last Name
Nickname
Employer/Firm Name
Title/Position
Preferred Email
Date of Birth(month) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec ,
Gender== select == Male Female Prefer not to say Other:
Preferred Language English French
Address
City
Prov/State== select == ==Canada== AB BC MB NB NL NS NT NU ON PE QC SK YT ==USA== AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MR MS MT NC ND NE NH NJ NM NN NV NY OH OK OR PA PL PO PR RI SC SD TN TT TX UT VA VI VT WA WI WV WY ==International== Other
Country== select == Canada United States --- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d'Ivoire Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe
Postal/Zip Code
Preferred Phone
1. Degree == select == B.Admin B.Comm B.Ed B.Hons B.SC BA BAA BAC Bachelor Bachelor of Management BBA BCL BMOS CÉGEP Community College High School LL.B M.Sc Master MBA MMPA Ph.D Other University Proof
2. Degree == select == B.Admin B.Comm B.Ed B.Hons B.SC BA BAA BAC Bachelor Bachelor of Management BBA BCL BMOS CÉGEP Community College High School LL.B M.Sc Master MBA MMPA Ph.D Other University Proof
3. Degree == select == B.Admin B.Comm B.Ed B.Hons B.SC BA BAA BAC Bachelor Bachelor of Management BBA BCL BMOS CÉGEP Community College High School LL.B M.Sc Master MBA MMPA Ph.D Other University Proof
1. Firm Position From To
2. Firm Position From To
3. Firm Position From To
What program are you applying for? == select == PCIC IA
Please read the below sections carefully, and only complete the questions applicable to the program you have selected.
Are you a member of CAIRP/Articling Associate? Y N
Is your firm a member of CAIRP? Y N
Upload completed Sponsor Declaration form
Name
Company/Firm Name
Business Telephone
Candidate Name
Yes I agree to undertake the responsibilities of a Presiding Officer, as outlined therein and in the 2019/2020 PCIC Information Package.
Yes I give my personal undertaking that I will maintain the confidentiality of and safeguard the exam documents provided to me prior to the examination.
Yes I agree to remain in the exam room until the exam is complete. Should I have to leave the examination room at any time during the exam, I will arrange for a replacement and submit a report to the Registrar’s office, signed by both myself and the person who acted as my replacement.
Yes In the event that I am unable to fulfill my commitment as Presiding Officer, I undertake to find an eligible substitute and to notify the CQP Office immediately so that the appropriate arrangements can be made.
Mailing Address
Email
*If you cannot find a LIT to assess your assignment you must contact CAIRP prior to your registration for the course. An assessment fee will be charged.
Summarize your work experience in insolvency, describing your present position and the nature and size of assignments on which you have worked, your level of responsibilities and description of duties. (This information will be kept in your student file and is strictly to provide background information on each new student)
Number of years/months of work in insolvency: yrs / months
Yes I hereby apply for registration in CAIRP's Insolvency Administration course. I agree to complete the online studies in a timely and professional manner, in accordance with the Course Policy and Guidelines. I agree to give immediate notice to the Association of any change of address, firm, or employer. I undertake not to apply to take the exam without having properly and successfully completed the nineteen-lesson course.
I further give my personal undertaking that I will safeguard the password given to me by D2L and maintain the confidentiality of the online Competency Assessments. I further declare that I will not allow any other person to view the online assignments either directly or indirectly, through use of my password and I acknowledge that the course material and Competency Assessments are and remain the property of the Association and that they may not be copied or reproduced.
I understand that this course will not lead to acceptance into the CIRP Qualification Program (CQP) also offered by the Association, nor will it exempt me from the normal pre-requisites to enter that program. I further declare that the foregoing is a true and correct record of my business experience.
Do you consent to receive email communications from us? Y N Note: If you are a CAIRP Member or Associate as defined in the Bylaws, there is certain information that CAIRP is required, either by law or regulation, to communicate to you which you cannot unsubscribe from. This includes, but is not limited to, notice of the Annual General Meeting and notice of annual membership renewal.
I wish to receive a hard copy of the Rebuilding Success magazine via mail. Y N
You are encouraged to answer the self-identification question below. Your response is voluntary and information collected is protected under the Privacy Act and the Personal Information Protection and Electronic Documents Act, and will be used for statistical purposes only.
Which of the following groups do you identify (you may self-identify in more than one group): Man Woman Another Gender Visible Minority Aboriginal Person with a disability
