4 Meadows Business Park • Station Approach •
Blackwater • Camberley GU17 9AB, UK
Tel: +44 (0) 1276 607140
Email:
Web: http://ict.concrete.org.uk /
CONCRETE TECHNOLOGY AND CONSTRUCTION EXAMINATIONS 2016
We need basic information about the candidates taking exams (registration), but the payment of fees may be completed after this form is returned to us.
1. Candidates should be registered using this form before 2 May 2016 for the following exams:
17 May 2016 - CT&C Stage 2: General Principles
18 May 2016 - CT&C Stage 3: Practical Applications
19 May 2016 - CT&C: Aggregates in Construction
2. Payment of exam fees is required by 2 May 2016, 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).
3. Please supply candidate(s) names and contact details. A separate table is supplied for each exam 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) (£80 GBP per exam)
Multiple candidate application / Overseas candidate(s) (£80 GBP per exam) + venue costs
2. Payment details: Indicate how you will pay by placing an ‘X’ against your preferred type. Payment amount to be in GBP only. Please quote reference CT&C-16 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. CANDIDATE DETAILSUse this form for single or multiple candidates. If all correspondence is to be through the training provider or exam centre, the address, telephone and email may be omitted for multiple candidates.
Examination(s)
Place X in box(es) / Exam Centre/Training Provider Name: / Country of exam:
Stage 2 General Principles / Stage 3 Practical Applications / Aggregates in Construction / First Name: / Surname: / Address: / Date of Birth: / Email:
3. CANDIDATE DETAILS
Use this form for single or multiple candidates. If all correspondence is to be through the training provider or exam centre, the address, telephone and email may be omitted for multiple candidates.
Examination(s)
Place X in box(es) / Exam Centre/Training Provider Name: / Country of exam:
Stage 2 General Principles / Stage 3 Practical Applications / Aggregates in Construction / First Name: / Surname: / Address: / Date of Birth: / Email:
3. CANDIDATE DETAILS
Use this form for single or multiple candidates. If all correspondence is to be through the training provider or exam centre, the address, telephone and email may be omitted for multiple candidates.
Examination(s)
Place X in box(es) / Exam Centre/Training Provider Name: / Country of exam:
Stage 2 General Principles / Stage 3 Practical Applications / Aggregates in Construction / First Name: / Surname: / Address: / Date of Birth: / Email:
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