CFA Institute Student Scholarship Verification Form June 2012 Level I Exam

This form must be submitted no later than 01 February 2012. You and your sponsoring professor must complete the below information and sign where indicated. Once your scholarship has been processed and approved, you will receive further instructions by email within four (4) weeks. A valid international travel passport is required for CFA Program enrollment/registration.

Return form to CFA Institute Scholarship Office: email to cmservices@cfainstitute.org or fax to +1 (434) 951-5290 SCHOLARSHIP FEE: US$350 eBook only US$410 Print only US$440 eBook and Print

Candidate Completes Following

CFA Institute ID Number: Name of College/University: Prefix (check one): First (Given) Name: Middle Name/Initial: Last Name (Surname): Mailing Address: Telephone: Email Address:
Yes Yes No No

Complete Candidate Section by typing into the editable form fields (if applicable) Date of Birth (d/m/yr): ___/___/____

____________________ Mr. Miss Ms. Mrs. Dr. Prof. Rev. Hon. _____________________________________ _____________________________________ _____________________________________
Important: your name on CFA Institute records must be the same as the name on your passport.

______________________________________________________ ______________________________________________________ ___________/______________/___________________

Country Code Area/City Code Local Number

______________________________________________________
Email address must be legible to allow receipt of important communications

I am a full time undergraduate student in my final year of study, and my professor is sponsoring me. I am a full- or part-time graduate student, and my professor is sponsoring me for a scholarship.

I certify that I am applying for the CFA Program for the first time and have never previously enrolled/registered.

Candidate Signature:

______________________________________________________
(date)

Professor Completes Following

Professors Name: College/University Name: College/University Address: Email Address: Telephone:

______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ ___________/______________/___________________

Country Code Area/City Code Local Number

CFA Institute ID Number-required: ______________________________________________

I certify that I am a full-time college/university professor faculty member at the above students university teaching a minimum of 6 credit hours per quarter or semester, or a college/university administrator teaching a minimum of 3 credit hours per quarter or semester. I also certify that I am a CFA Institute charterholder in good standing and am not in a Retired membership status. Professors Signature/date: ____________________________________________________ Plan early! CFA Institute will not accept forms received after 1 February 2012. For the current exam offering, the CFA Program enrollment fee (if applicable) is waived. Scholarship applicants pay a discounted registration fee along with curriculum and shipping costs plus any applicable taxes and import duties. Scholarships cannot be deferred to another exam offering.
Office Use Only: Prepaid Will register online Refund due Offer Code: SCHSTU__________ Date: _____________________ Authorization: _________________________ EMAIL______