IFAC Candidate Information Form

<strong>IFAC</strong> <strong>Candidate</strong> <strong>Information</strong> <strong>Form</strong> 1<br />

For assistance with the form, please refer to the Help Sheet.<br />

Nomination For<br />

Nomination Type<br />

Last Name<br />

First Name<br />

Title<br />

Address Line 1<br />

Address Line 2<br />

State/Province<br />

Postal Code<br />

Telephone<br />

Email<br />

Fax<br />

Country of Residence<br />

Alternative Country of Representation<br />

Explanation for Alternative Country<br />

Nominating Organization 1<br />

Nominating Organization 2<br />

Nominating Organization 3<br />

Nominating Organization 4<br />

Nominating Organization 5<br />

Gender<br />

Profession<br />

1 Please save the <strong>Candidate</strong> <strong>Information</strong> <strong>Form</strong> to your computer, complete it, save it again, and submit it via email<br />

to nominations@ifac.org by March 15, 2010.

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<strong>IFAC</strong> <strong>Candidate</strong> <strong>Information</strong> <strong>Form</strong> 1<br />

If other, please describe<br />

Nationality<br />

Primary Language<br />

Written English Proficiency<br />

Spoken English Proficiency<br />

Professional Designation<br />

Current Employer<br />

Professional Affiliations<br />

Previous Involvement with <strong>IFAC</strong><br />

Educational Background<br />

Career History and Professional Experience<br />

List the candidate’s key achievements relating to the accountancy<br />

profession, e.g., in standard setting, business, or government<br />

Explain why the candidate wishes to be appointed<br />

Explain the candidate’s objectives for this position<br />

Explain how the candidate’s skills, knowledge, and experience are relevant<br />

to this position<br />

Please list up to ten major published works<br />

Has the candidate ever been subject to disciplinary action by accounting<br />

bodies, regulators, or others?<br />

If yes, please explain<br />

The candidate confirms to his/her availability for the estimated annual time<br />

commitment as stated for this position in the Call for Nominations.<br />

The candidate applies for the Travel Subsidy for Developing Nations. See<br />

pages 8-10 of the Call for Nominations<br />

The candidate will notify the Nominating Committee as soon as possible if<br />

his/her employing organization, employment status, or country of<br />

residence changes

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<strong>IFAC</strong> <strong>Candidate</strong> <strong>Information</strong> <strong>Form</strong> 1<br />

The candidate would be willing to accept a technical advisor from another<br />

nominating organization<br />

Nominating Contact <strong>Information</strong><br />

Contact Last Name<br />

Contact First Name<br />

Contact Title<br />

Address Line 1<br />

Address Line 2<br />

Contact State/Province<br />

Contact Postal Code<br />

Contact Telephone<br />

Contact Fax<br />

Contact Email<br />

Is this a joint nomination?<br />

Is the candidate being considered for multiple nominations?<br />

Is the candidate being renominated?<br />

What type of support will the nominating organization provide?<br />

The nominating organization will support the candidate in case of<br />

appointment. This support includes that no undue influence, financial or<br />

otherwise, will be exerted that might impair the member’s ability to act with<br />

independence, integrity and in the public interest<br />

Please note that if the candidate is appointed, the information in this form will be used to compile a short<br />

biography for publication on the <strong>IFAC</strong> website. The candidate will have an opportunity to review his or her<br />

biography before it is published.