Board of Studies (Academic)
Application for Empanelment as Mentor for CA Aspirants
Membership Number of ICAI
Date of Birth
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Membership Since
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Applicant's Photograph
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1. Applicant's Name
Full Name
2. Gender
--Select--
Male
Female
3. Date of Birth
4. Correspondance Address
State
City
Pincode
5. Email Address
6. STD Code
Telephone Number 1
Telephone Number 2
Telephone Number 3
7. Mobile No.
Alternate Mobile No.
8. Membership Number of ICAI
9. Membership Status
10. Membership Since
11. Region
12. Provide Area where you may guide Students?
Subject specific Guidance
Motivation Guidance
Professional Guidance
Preferred Course of Students to Mentor?
Foundation
Intermediate
Final
Paper-1: Accounting
Paper-2: Business Laws
Paper-3: Quantitative Aptitude
Paper-4: Business Economics
Paper-1: Advanced Accounting
Paper-2: Corporate and Other Laws
Paper-3: Taxation (Section A: Income-tax Law & Section B: Goods and Services Tax)
Paper-4: Cost and Management Accounting
Paper-5: Auditing and Ethics
Paper-6: Financial Management and Strategic Management
Paper-1: Financial Reporting
Paper-2: Advanced Financial Management
Paper-3: Advanced Auditing, Assurance and Professional Ethics
Paper-4: Direct Tax Laws & International Taxation
Paper-5: Indirect Tax Laws
Paper-6: Integrated Business Solutions (Multidisciplinary Case Study with Strategic Management)
13. Mode of Mentorship Preferences?
In-Person Meetings
Online Sessions and Hybrid (Both Online & In-Person)
14. Availability for Mentorship From Date
15. Availability for Mentorship To Date
16. Availability for Mentorship Time
17. Post Qualification Courses pursued (Conducted by ICAI)?
No
Yes
Course Name
--Select--
Computer Accounting and Auditing Techniques
Corporate Management Course
Information and Systems Audit
Insurance Risk Management
International Trade Laws and WTO
Management Accountancy Course
SAP FA and MA Module, Microsoft Dynamics NAV
Tax Management Course
Course Period (From - To)
Date of Certificate
+Add
#
Course Name
Course Period
Date of Certificate
Action
18. Certificate Courses pursued (Conducted by ICAI)?
No
Yes
Select Certificate
--Select--
Certificate Course on Business Responsibility and Sustainability Reporting
Certificate Course on Arbitration
Certificate Course on Concurrent Audit of Banks
Certificate Course on Derivatives
Certificate Course on Enterprise Risk Management
Certificate Course on Forensic Accounting and Fraud Detection
Certificate Course on Forex and Treasury Management
Certificate Course on Indian Accounting Standards
Certificate Course on Indirect Taxes
Certificate Course on Internal Audit
Certificate Course on International Financial Reporting Standards
Certificate Course on International Taxation
Certificate Course on Master in Business Finance
Certificate Course on Valuation
Course Period (From - To)
Date of Certificate
+Add
#
Certificate Name
Course Period
Date of Certificate
Action
19. Any other Post Qualification or Certificate course pursued outside ICAI with details.
20. Other Academic Qualification
21. Any major distinctions during higher studies
22. Industry working Experience: (starting from last to first)?
No
Yes
Designation
Company Name
Period From
Period To
+Add
#
Designation
Company Name
Period From
Period To
Action
23. Professional Achievements/ Significant contributions:
24. Whether any Disciplinary action initiated and pending against you (referred to Disciplinary Committee/Board for Enquiry)?
No
Yes
Please give details (if available)
25. Any other association with ICAI?
No
Yes
Name of the Committee
Period of association
I hereby declare that
I Possess
years post qualification experience of audit and / finalisation of accounts working in industry.
I am currently active in the practice/working in Industry.
I shall guide the student to the best of my abilities.
The information given above is true and correct and nothing has been concealed therefrom.
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