Certified Professional of IT (CPIT)

One-Way Recognition – CPIT(PM)

Certificate Application Form

INSTRUCTIONS:

  1. Complete all sections using block letters or by typing.
  1. Separate sheets may be attached if the space provided is insufficient.
  1. Photocopies of supporting documents (in A4 size) must be provided for all academic, professional qualifications and working experiences. Original documents must be presented to the office of The Hong Kong Institute for IT Professional Certification (HKITPC) upon request.

REQUIREMENTS:

  1. Holder of international credential with valid certification status.

For CPIT(Project Manager), PMP Certification in good standing is required.

  1. In possession of an academic qualification of at least at Level Four (4) according to the Hong Kong Qualifications Framework in IT or an IT-related area, for example, an Associate Degree, Higher Diploma or Undergraduate Degree in IT, Computer Studies, Computer Scienceor Computing.
  1. In possession of IT Project Management experience.

For CPIT(Project Manager), five years of project management experienceis required.

SECTION 1 – PERSONAL PARTICULARS

Title: / Dr/ Ir/ Prof/ Mr/ Mrs/ Ms / Gender: / Female/Male
Family Name: / Given Name:
Chinese Name: / Date of Birth: / (DD/MM/YYYY)
HKID/ Passport No.*: / Nationality:

* Only one legal identity information is required

Company Name:
Company Address:
Position: / E-mail :
Tel No.: / Fax No.:
Residential Address:
Mobile: / E-mail :
Tel No.: / Fax No.:

Preferred mailing address: Office Home

Preferred e-mail address: Office Home

SECTION 2 – Certification Titles

Please check the CPIT Certificate you are applying:

Project Manager (PM)

SECTION3 – QUALIFICATIONS

A)Academic Qualifications

From
(MM/YYYY) / To
(MM/YYYY) / Institution/ University
(please specify the country in which you attended the course) / Awards and Date attained
(please indicate title of awards, honors or cumulative grade if applicable ) / Major Subject/Discipline

B)Professional Qualifications

Title/ Qualification / Class
(if applicable) / Professional Body / Date
Qualified
(DD/MM/YYYY) / Reference/ Membership Number

SECTION 4 –WORK EXPERIENCE

From
(DD/MM/YYYY) / To
(DD/MM/YYYY) / Position / Employer
Company Name:
Address:
E-mail:
Tel: / Fax:
Referee:
Tel: / Fax:
Duties:
From
(DD/MM/YYYY) / To
(DD/MM/YYYY) / Position / Employer
Company Name:
Address:
E-mail:
Tel: / Fax:
Referee:
Tel: / Fax:
Duties:
From
(DD/MM/YYYY) / To
(DD/MM/YYYY) / Position / Employer
Company Name:
Address:
E-mail:
Tel: / Fax:
Referee:
Tel: / Fax:
Duties:

SECTION 4b – DETAILED WORK EXPERIENCE

From the above-mentioned work experience, describe 2 projects and elaborate as per questions 1 to 4.

Project ID / Project Title
A
B

Q1) Project Overview – For each of the selected projects, describe briefly the objectives, requirements, intended benefits and deliverables.

Project ID / Objectives / Requirements / Intended Benefits / Project Deliverables / Major Project Issues & Resolutions (Maximum 500 words per project)
A
B

Q2) Project Scale – For each of the selected projects, describe briefly the following attributes

Project Cost

Project Duration

Size of Team

Project Delivery Schedule

Project ID / Project Cost / Duration / Size of Team / Project Delivery Schedule
A
B

Q3) Role &Responsibility – For each of the selected projects, describe briefly the role and responsibilities which were performed by the applicant

Project ID / Role & Responsibility (Maximum 100 words per project)
A
B

Q4)Application of Knowledge Areas – For each of the selected projects, please provide a high level description of the approach (1 paragraph) used in the application of the following knowledge areas throughout the project lifecycle.

Project ID / Knowledge Area (Maximum 200 words per project)
A / Local Law:
Information Technology:
Business Knowledge:
Project ID / Knowledge Area (Maximum 200 words per project)
B / Local Law:
Information Technology:
Business Knowledge:

SECTION5 – METHOD OF PAYMENT

The fee of CPIT(PM) certificate is HK$1,500.00

Please enclose a crossed chequemade payable to “The Hong Kong Institute for IT Professional Certification Limited”.

Bank: / Cheque No.:

SECTION 6 – DECLARATION BY APPLICANT

  1. I declare that all information provided by me in this form and all information provided in supporting this application are trueand accurate. I am aware that any fraudulent or dishonestprovision of information may disqualify my application, qualification and credential obtained from the HKITPC.
  2. I authorize the HKITPC to releaseinformation given in this applicationto third parties for the confirmation of my qualifications and experiences.
  3. I understand that HKITPC reserves the right to approve or reject this application.
  4. I have read and I shall comply with the application requirements, rules, procedures, guidelines and assessment methods as stipulated by the HKITPC.
  5. I understand that the Certification Fee for this application is non-refundable and non-transferable.
  6. I have notbeen convicted of any criminal offence within the last seven years.

Name of Applicant (in block letters)SignatureDate

CPIT(PM) Certificate Application Form No. 2 (Version 1.1) – 1 July 20141of11