Higher Education Qulaifications

Higher Education Qualifications RE-ENTRY FORM (Candidates who were unsuccessful in the September 2012 session)

March/April 2013 Examinations Only Entry Closing Dates: 31 January 2013 If you do not return this form by the appropriate closing date your entry will not be processed. Thank you.

Personal details: BCS Reference number: Surname/last name/family name:

First name/s:

Email address:

Mobile/contact number:

Approved Centre details: Are you currently enrolled on a course of study towards the BCS Higher Education Qualifications? () Yes – Name of Approved Centre: No (Your Approved Centre will be kept informed of your examination results)

Re-entry - Examination module/s (tick module/s below)

Certificate Diploma Professional Graduate Diploma

Information Systems Professional Issues in Is Practice Advanced Database Man Sys Software Development Object Oriented Programming Computer Services Management Computer & Network Technology Computer Networks Management Information Systems Systems Analysis and Design Software Engineering 2 Database Systems IT Project Management Examination venues: (tick below)

UK International

Bristol India ( Bangalore Kolkata Mumbai New Delhi) – indicate city Edinburgh Mauritius (Reduit) Nigeria (Lagos) London Pakistan ( Islamabad Karachi Lahore Peshawar) – indicate city Manchester Sri Lanka ( Colombo Jaffna Kandy) – indicate city Other venue (please name)…………………………………..…………and pay additional £60 venue surcharge Payment Details:

You can pay by cheque, credit card or debit card (please tick as appropriate). Cheque (please make cheques payable to BCS)

Credit/debit card*

*For security reasons to pay by credit/debit card please contact our Customer Service team on +44 (0) 1793 417424.

Confirmation to be signed by all candidates: (Please check all details carefully, as later amendments cannot be guaranteed)

I confirm that the information given on this form is correct

Signature:

Email to: [email protected] or post to Membership & HEQ department BCS The Chartered Institute for IT, 1st Floor, Block D, North Star House, North Star Avenue, Swindon, Wiltshire, SN2 1FA United Kingdom. Tel: +44 (0) 1793 417424.

Re-entry form v0.1 July 2011 1/2