Concrete Technology and Construction Examinations 2017
4 Meadows Business Park • Station Approach •
Blackwater • Camberley GU17 9AB, UK
Tel: +44 (0) 1276 607140
Email:
CONCRETE TECHNOLOGY AND CONSTRUCTION EXAMINATIONS 2017
STAGE 1: CONCRETE PRACTICE
We need basic information about the candidates taking exams (registration) and payment of exam fees.
- Candidates should be registered using this form before 31 November 2017 for the following exam: 6 December 2017 (11:00 a.m. start) – CT&C Stage 1: Concrete Practice
- Payment of exam fees is required by 31 November 2017 as appropriate, in order that preparations for the exams may be finalised. Exam fees are non-refundable after this date. Candidates will not be allowed to sit the exam, if payment has not been made and cleared (see 2. below).
- Please supply candidate(s) names and contact details. A separate table is supplied on the following pages. Email this completed document to the ICT email address above.
1. Registration type: Place an ‘X’ in the appropriate boxes:
Single candidate application / UK candidate(s) (£50.00 GBP per exam)
Multiple candidate application / Overseas candidate(s) (£50.00 GBP per exam) + venue costs
2. Payment details: Please complete one of the below to indicate payment method. Payment amount to be in GBP only. Please quote reference CP-17 or invoice numbers with the payment.
Debit or credit card (VISA/MasterCard/Maestro, but not AMEX) amount: £
Fill in card details below, or phone +44 (0)1276 607148, or email:
Card type: / Number:
Start date: / Expiry date: / Security number: / Issue number:
Name on the card:
Payment will be made by my employing organisation, please invoice:
Employer name:
Employer address:
Purchase order number:
Contact name/job title:
Contact telephone/email address:
For BACS payments, amount: £
HSBC Bank plc, London Road, Twickenham, Middlesex. TW1 3RY
Account number: / 11484354 / Please note:
The candidate must pay any bank charges when using BACS/ IBAN/ BIC /SWIFT
Sort code: / 40-44-39
Account name: / The Concrete Society Ltd
IBAN: / GB09MIDL40443911484354
BIC/SWIFT: / MIDLGB22
Enclosed cheque (payable to ‘The Concrete Society’) amount: £
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3. STAGE 1: CONCRETE PRACTICE – CANDIDATE DETAILSUse this form for single or multiple candidates. If all correspondence is to be through the training provider or exam centre, the address and email may be omitted for multiple candidates.
Exam Centre/Training Provider Name/Email: / Country of exam:
First Name: / Surname: / Address: / Date of Birth: / Email:
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