Cisa Application for Cisa Certification 62011 Form 2012

A minimum of five years is required to qualify for CISA Certification. No more than three years of experience substitution or educational waivers can be used towards your five year experience requirement with the exception of those claiming the experience substitution of a university instructor. check the boxes on page V-2 of the verification form that indicate the tasks you performed that are being verified by each verifier. All Verification of Work Experience forms pages V-1 and V-2 must be signed by your verifier and submitted along with your application. To reduce processing time please send the completed verification forms with your application. In order for your application to be efficiently processed please collect all supporting documentation verification of work experience form s and any applicable university transcript or letter and submit your completed Application for CISA Certification via fax email or mail to ISACA 3701 Algonquin Road Suite 1010 Rolling Meadows IL 60008-3124 USA E-mail certification isaca.org NOTE Please allow approximately eight weeks for the processing of your completed Application for CISA Certification. Upon approval you will receive a certificate package via mail containing a letter of certification and your CISA certificate. Page A-1 Name Exam ID First Middle Initial Last/Family Maiden Name or Former Name s Preferred Mailing Address Home Business Home Address City State/Country Zip/Postal Code Home Telephone Email Present Employer Your Job Title Business Name Business Address Business Telephone E-mail Immediate Supervisor Name I hereby apply to ISACA for issuance to me of Certification as a Certified procedures and regulations of ISACA. I have read and agree to the conditions set forth in the CISA Application for Certification and Continuing Education Policy in effect at the time of my application covering the Certification process and Continuing Education policies. Please note that if year length of employment with your most recent company is less than three months verification of work forms. All Verification of Work Experience forms pages V-1 and V-2 must be signed by your verifier and submitted along with your application. To reduce processing time please send the completed verification forms with your application. In order for your application to be efficiently processed please collect all supporting documentation verification of work experience form s and any applicable university transcript or letter and submit your completed Application for CISA Certification via fax email or mail to ISACA 3701 Algonquin Road Suite 1010 Rolling Meadows IL 60008-3124 USA E-mail certification isaca.org NOTE Please allow approximately eight weeks for the processing of your completed Application for CISA Certification. Upon approval you will receive a certificate package via mail containing a letter of certification and your CISA certificate. Page A-1 Name Exam ID First Middle Initial Last/Family Maiden Name or Former Name s Preferred Mailing Address Home Business Home Address City State/Country Zip/Postal Code Home Telephone Email Present Employer Your Job Title Business Name Business Address Business Telephone E-mail Immediate Supervisor Name I hereby apply to ISACA for issuance to me of Certification as a Certified procedures and regulations of ISACA. If one person cannot verify all required experience for you to become a CISA previous employers must be asked to complete this form. If you currently or once worked as an independent consultant you can use a knowledgeable client or an individual certified as a CISA or CISM to perform this role. Please note that if year length of employment with your most recent company is less than three months verification of work forms. All Verification of Work Experience forms pages V-1 and V-2 must be signed by your verifier and submitted along with your application. To reduce processing time please send the completed verification forms with your application. In order for your application to be efficiently processed please collect all supporting documentation verification of work experience form s and any applicable university transcript or letter and submit your completed Application for CISA Certification via fax email or mail to ISACA 3701 Algonquin Road Suite 1010 Rolling Meadows IL 60008-3124 USA E-mail certification isaca.org NOTE Please allow approximately eight weeks for the processing of your completed Application for CISA Certification. Upon approval you will receive a certificate package via mail containing a letter of certification and your CISA certificate. A-2 Verification of Work Experience page 1 of 2 Printed Name employer s. The individual verifying the work experience must be an independent verifier and not of any relation to the applicant nor can the applicant verify his/her own work. If I currently or once worked as an independent consultant I can use a knowledgeable client or an individual certified as a CISA or CISM to perform this role. I would appreciate your cooperation in completing this form by verifying my IS auditing control assurance or security work experience as noted on my application form attached and as described by CISA job practice area and task statements see page V-2. I would appreciate your cooperation in completing this form by verifying my IS auditing control assurance or security work experience as noted on my application form attached and as described by CISA job practice area and task statements see page V-2. Please return the complete form to me for my submission to ISACA. If you have any questions concerning this form please direct them to certification isaca.org Thank you Applicant s Signature Employer s Verification Please answer all six questions and sign and date the form. Verifier s Name Job Title Address STREET CITY STATE/PROVINCE/COUNTRY POSTAL CODE Company Telephone Number Company E-mail I am attesting to/verifying the employment experience listed on page A-2. Enter employer name s. List all that apply to this verification. Have you functioned in a supervisory position to the applicant or am otherwise qualified to verify the experience as listed on page A-2 Yes No If no please explain what qualifies you to verify this information Is the categorization and duration of the applicant s work for certification form correct to the best of your knowledge Are you qualified and willing to verify the applicant s work experience prior to his/her affiliation with your company/organization N/A experience waiver s claimed Is there any reason you believe this applicant should not be certified as an information systems auditor Verifier s Signature V-1 Page V-2 Applicant Name Applicant required to indicate with an x in each box the task they performed to be confirmed by the verifier. Enter employer name s. List all that apply to this verification. Have you functioned in a supervisory position to the applicant or am otherwise qualified to verify the experience as listed on page A-2 Yes No If no please explain what qualifies you to verify this information Is the categorization and duration of the applicant s work for certification form correct to the best of your knowledge Are you qualified and willing to verify the applicant s work experience prior to his/her affiliation with your company/organization N/A experience waiver s claimed Is there any reason you believe this applicant should not be certified as an information systems auditor Verifier s Signature V-1 Page V-2 Applicant Name Applicant required to indicate with an x in each box the task they performed to be confirmed by the verifier. Description of CISA Job Practice Areas 1 The Process of Auditing Information Systems Provide audit services in accordance with IT audit standards to assist the organization with protecting and controlling information systems. Tasks Develop and implement a risk-based IT audit strategy in compliance with IT audit standards to ensure that key areas are included. Plan specific audits to determine whether information systems are protected controlled and provide value to the organization. Conduct audits in accordance with IT audit standards to achieve planned audit objectives. Please return the complete form to me for my submission to ISACA. If you have any questions concerning this form please direct them to certification isaca.org Thank you Applicant s Signature Employer s Verification Please answer all six questions and sign and date the form. Verifier s Name Job Title Address STREET CITY STATE/PROVINCE/COUNTRY POSTAL CODE Company Telephone Number Company E-mail I am attesting to/verifying the employment experience listed on page A-2. Enter employer name s. List all that apply to this verification. Have you functioned in a supervisory position to the applicant or am otherwise qualified to verify the experience as listed on page A-2 Yes No If no please explain what qualifies you to verify this information Is the categorization and duration of the applicant s work for certification form correct to the best of your knowledge Are you qualified and willing to verify the applicant s work experience prior to his/her affiliation with your company/organization N/A experience waiver s claimed Is there any reason you believe this applicant should not be certified as an information systems auditor Verifier s Signature V-1 Page V-2 Applicant Name Applicant required to indicate with an x in each box the task they performed to be confirmed by the verifier. Description of CISA Job Practice Areas 1 The Process of Auditing Information Systems Provide audit services in accordance with IT audit standards to assist the organization with protecting and controlling information systems.