UNIT 2A
KILNAP BUSINESS & TECHNOLOGY PARK
OLD MALLOW ROAD
CORK
IRELAND
Tel: +353 21-4909700, Fax: +353 21-4308364
Email: , Web:
APICS CPIM EXAMINATION REGISTRATION FORM
Name: / (Full name as you would like it to appear on your certificate)
Date of Birth: / APICS ID
(please provide) / IPICS Member?
Y/N
Company Name: / (If work address is being used for correspondence)
Postal Address:
Daytime Tel. No:
Email Address:
Please note; admission tickets and results will be sent by email
Exam Date: / 12th March 2011 25th June 2011 3rd December 2011
Exam Venue /
Cork Dublin Galway Limerick
Exam / Morning Examinations / Afternoon Examinations
Exam (tick one in the morning and/or one in the afternoon)
Basics of Supply Chain Management BSC /
Master Planning of Resources MPR
Detailed Scheduling and Planning DSP /
Strategic Management of Resources SMR
Execution and Control of Operations ECO
How have you studied for the exam? / Self study
/ Company training provided
Distance Learning / Public Course (please specify college below)
Please return with your cheque for €190 (member) / €215 (non member) made payable to IPICS to the address above.
Please complete the section below to facilitate payment via Credit/Debit Card:
Name of Cardholder:______
Type of Card: MasterCard Visa Laser
Credit Card Number: Expiry Date: ______
Security Number (last 3 digits on reverse of card): ______
Cardholder Signature: ______Date:______
CPIM/CSCP EXAMINATIONS DEADLINES AND FEES:
REGISTRATION DEALINE
Please consult for dates.
RE-SCHEDULING DEADLINE
In order to re-schedule or defer an exam a written request must be sent to IPICS, no later than 35 working days before the exam date. Re-schedules or deferrals will not be accepted after this date. Any candidate who chooses to reschedule or defer an exam can only defer to the next sitting. (I.e. Deferral or re-schedule from March to June, or June to December etc.)
CANCELLATION DEADLINE
In order to cancel an exam a written request must be sent to IPICS, no later than 35 working days before the exam date. Cancellations will incur a cancellation charge of €50.00 for CPIM examinations and €200.00 for CSCP examinations. Cancellations within 10 working days before the exam will not be accepted and will forfeit the entire exam fee.
MEDICAL CANCELLATION DEADLINE
Medical cancellations will be accepted no later than 10 days after the exam date. Any candidates who cancel on medical grounds must provide a medical certificate or will forfeit the entire exam fee.
Please see the CPIM Exam Registration Procedures and CSCP Exam Registration Procedures on our website
Company Limited by Guarantee. Registered office: IPICS The Supply Chain Management Institute
Unit 2A, Kilnap Business & Technology Park, Old Mallow Road, Cork, Ireland. Registration No. 87310
Associate of APICS - Association for Operations Management (USA)