Please complete all appropriate sections on this form and return to NOCN alongside all relevant documentation as detailed in Section 7.

SECTION 1 – CENTRE DETAILS

Centre Name: / Click here to enter text. /
Centre Number: / Click here to enter text. /
Contact Person: / Click here to enter text. /
Contact Number: / Click here to enter text. /

SECTION 2 – LEARNER DETAILS

Learner’s Full Name:
(as it should appear on certificate) / Click here to enter text. /
Date of Birth: / Click here to enter text. / Learner Number: / Click here to enter text. /

SECTION 3 – QUALIFICATION/COURSE DETAILS

Qualification/Course Name: / Click here to enter text. /
Course Start Date: / Click here to enter text. / Course End Date: / Click here to enter text. /
Award/Exam Date: / Click here to enter text. / Run ID (if known): / Click here to enter text. /

SECTION 4 – REASON FOR REPLACEMENT/RE-ISSUE OF CERTIFICATE

Please mark the appropriate reason for replacement below with a tick and follow the required actions.

Damaged / ☐ /
  • The original certificate must be included when returning this form.
  • Explain how the certificate was damaged below.

Spelling Error / ☐ /
  • The original certificate must be included when returning this form.
  • You are required to include a copy of the learner’s ID (see Section 5).

Lost / ☐ /
  • Please explain below how the certificate was lost below.

Other / ☐ /
  • Please state below.

Please provide relevant explanation as requested above:
Click here to enter text.

SECTION 5 – AUTHENTICATION (only required for requests in relation to Security qualifications)

A photocopy of one of the below must be submitted with this form (along with the original certificate) for any amendments to be made to the spelling of a learner’s name who has studied on an NOCN Security qualification. Please indicate below which document you have submitted:

Passport / ☐ / NHS Card / ☐ / Birth Certificate / ☐ /
Driving License / ☐ / Identity Card / ☐ / EU Photo ID Card / ☐ /

SECTION 6 – PAYMENT

Please select your payment option below. The replacement certificate will only be issued on receipt of the appropriate fee of £40.00.NOCN will investigate the reason for the re-issue of a certificate (as provided in section 4), if it is deemed to be NOCN’s error you will not be charged.

Credit/Debit Card / ☐ /
  • Please contact us on 0300 999 1177 to pay for your replacement over the phone. There is an additional charge of 2.5% for card payments.

Cheque
/ ☐ /
  • Please make your cheque payable to NOCN and write your cheque guarantee card number on the reverse. NOCN will not process your replacement until payment has cleared.

Postal Order / ☐ /
  • NOCN will not process your replacement until payment has cleared.

Centre Invoice
Purchase Order No. Click here / ☐ /
  • Please indicate a purchase order number (if required).

Please sign below to confirm the details on this form are correct and that you authorise NOCN to take paymentout of your account. Your replacement will not be processed if this is not completed.

Authorised Signature: / Click here to enter text. / Date: / Click here to enter text. /

SECTION 7 – ISSUE OF REPLACEMENTS
Please return this form and all supporting documentation via recorded delivery to:

Customer Services Team

NOCN

The Quadrant

99 Parkway Avenue

Sheffield

S9 4WG

If you are paying by credit or debit card, please contact NOCN who will take payment from you over the phone.

Upon receipt of a correctly completed form containing all required documentation, NOCN will aim to process your replacement within 5 working days. Your replacement will be sent to your Centre’s normal certification address. For any queries in regards to replacement certificates please email .

V4.0March2018