Information Systems Examinations Board

INFORMATION SYSTEMS EXAMINATIONS BOARD

CERTIFICATE IN DATA PROTECTION

Candidate Registration Form (Direct Entry Only) /

Candidate No.

(Office use only)

Please complete form in BLOCK letters

Surname /

Title (Mr, Ms, etc)

Other Names /

Date of Birth

(Mandatory field for identification purposes)
Home Address / Work Address

Home Telephone Number

Work/Daytime Telephone Number

Email address:

Education: Highest qualification achieved (e.g. BSC, GCSE etc) and date achieved

Date

Qualification

Experience:

Years

Months

Current Job Title:

Did you:
(Select one) / Attend an accredited training course?
Y / N / Take accredited computer based training? (if available)
Y / N / Self Study?
Y / N
Dates of course attended / Name of Training Provider
Please PRINT how you would like your name to appear on the certificate
Candidate’s Signature ……………………………………………………………….. Date …………………….
If you are a BCS member please quote Membership Number
Is English your 1st language? Y / N / If no, please tell us what is
When completed, this form should be sent to:

ISEB (DP), Ground Floor, Block D, North Star House, North Star Avenue, Swindon, Wiltshire SN2 1FA

Telephone: 01793 417418 Fax: 01793 417 559

DATA PROTECTION ACT NOTICE
The British Computer Society will hold your personal data on its computer database. This information may be accessed, reviewed and used by the Society for administrative purposes (for example, processing your membership application/renewal and contacting you in respect of your membership) and conducting market research. All of these purposes have been notified to the Information Commissioner. If you are based outside the European Economic Area (the “EEA”), information about you may be transferred outside the EEA.
The Society, or its approved suppliers, may also send you details of products and services you may be interested in. If you do not wish to receive such information, please tick the box and attach this notice to your completed application form before returning to the BCS.

PLEASE COPY AS MANY TIMES AS NECESSARY

Please read the notes below before completing this form.
Candidates applying for exemption to accredited training direct to ISEB are required to demonstrate that at least 70% of the ISEB syllabus, in terms of both topic and weighting, has been coveredEITHERduring other training courses OR through work experience which has been signed off by a senior line manager
Applications for exemption from accredited training must include documented evidence of other courses attended or relevant work experience (including dates). In particular, information must be supplied as to the topics covered in the courses / work experience and the length of time devoted to individual subjects. Please enclose copies of certificates where necessary.
Candidates are responsible for ensuring that sufficient evidence is provided
Payment of Direct Entry Assessment fees: Please enclose a cheque made payable to the British Computer Society for the correct fee including VAT (please refer to for current fee list)
The completed form (and other training documentation), together with your assessment fee should be sent to the DP Examinations Officer at the address above.
Please ensure that you have a refer to the syllabus and Guidance for Candidates documentation
Record of Data Protection Training
Name (in full):
Training Provider Name:
Address:
Name of Course(s):
Date(s) course taken (from … to)
Syllabus area(s) covered (syllabus section / subsection, number and heading)
Examination Date:
Result (please supply a copy of certificate awarded):
Supporting Documentation (Copies of Certificates, Training Documentation etc)