QUALIFICATION - APPLICATION TO REGISTER FOR CERTIFICATE

Surname: Title:
Forenames:
Home Address:
Date of Birth (dd/mm/yy):
Home Telephone no.:
Office Telephone no.:
Home E-Mail address:
Office E-Mail address:
AEA membership no.:
Academic Qualifications: (please give dates, levels/grades, awarding body)
Degrees or similar level:
Professional/Vocational qualifications:
Secondary Education:
Employer:
Department:
Post Title:
Date appointed to present post:
Description of present duties:

A candidate is not able to register for the Certificate unless he/she can either demonstrate a minimum of three years' work experience in both electoral registration and elections administration or have registered for and completed/will complete the Foundation course in that year or a previous year. Please complete the following section to indicate which of the above two routes you fulfil.

1. I attended the Foundation course in (state year(s)) and completed/will complete all five modules. 

or

2. I have completed a minimum of three years' work experience in both electoral registration and elections administration. 

Please tick appropriate box and, if you have ticked against 2, complete the section below.

PREVIOUS JOB EXPERIENCE:

List your previous posts in electoral registration/elections in chronological order starting with the most recent job (prior to your present post).

Authority / Job Title / Dates / Main Duties
Please detail any areas of the syllabus in either module where you have no relevant work experience:
C1 - Registration of Electors
C2 - Elections Administration

I certify that the information given in this application is true. I confirm that I have read the Rules relating to the Qualification and that I understand that I am responsible for:

(a) compliance with the Rules;

(b) preparing for the Qualification under my own arrangements;

(c) undertaking such preparation and study which is required;

(d) being and remaining a member of the AEA.

I hereby apply to register for the Certificate in Electoral Administration.

Signed...... Date......

I confirm the above and that the applicant has the support of the Council to undertake the above Qualification.

Signed...... Date......

Name ......

Position ......

Council...... Telephone no......

Fees to be invoiced:
Item / Amount
Registration / £661
Assignments (four) (£139 each) / £556
Examinations (£184 each) / £368

Please tick appropriate boxes and enter total amount to be invoiced here - £......

Purchase order no. (if appropriate) …………………………………………..

Notes

  1. You will be invoiced for the fees that you have indicated above. This must include at least the registration fees. All fees are subject to vat.
  2. This form must be lodged with the Association by no later than 1 September by emailing it to .