Request for Intermediate LevelExamination Papers
To be completed by the Exam Secretary.All sections must be completed.
Click the grey box to start typing.
Return it to or post to Exams, RSGB, 3 Abbey Court, PrioryBusinessPark, Fraser Road, BedfordMK44 3WH.
SECTION A / Exam Secretary(Click the grey box to start typing)Name: / Callsign:
Mailing Address for examination papers: / Post Code:
Mobile: / Telephone:
Email Address:
SECTION B / Exam Details / We require 2 weeks notice for Intermediate Examination Papers
Club Name: / 1st Named Invigilator: / Any Instructor associated with the training course cannot be the 1st Named Invigilator
Centre Registration No: / Assistant Invigilator:
Examination Date: / Assistant Invigilator:
Start time: / Reader (if required):
Number of Papers: / Main Instructor:
Full address of Examination Venue: / Registered Assessor: / Registration:
SECTION C / Comments and Special Requirements
The Radio Communication Examinations are administered by the Radio Society of Great Britain on behalf of the Radio Communication Foundation.
EX204 REP-I Request for Intermediate Papers_ August 2013
SECTION D / CandidatesTitle / First Name / Middle Name / Surname / Callsign / Full Address / Post Code / Date of Birth
SECTION E / Payment - £32.50 per candidate Use the RSGB Shop Exam page or send a cheque payable to the RSGB
I am paying for candidates.
I have paid the full amount using the RSGB Shop. My receipt number is
I am sending a cheque for the full amount to the RSGB.
SECTION F / Exam Secretary
I confirm that the details given above are correct. Signature: Date:
We aim to get the Examination Papers to you a week before the exam. Please contact the RSGB on 01234832717 if you have not received them.
The Radio Communication Examinations are administered by the Radio Society of Great Britain on behalf of the Radio Communication Foundation.
EX204 REP-I Request for Intermediate Papers_ August 2013