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General Certificate in Packaging DATE RECEIVED: PAYMENT METHOD: Th St 9 May 2014 Application Deadline: 1 March 2014 PAYMENT DATE: AMOUNT CHARGED: £

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General Certificate in Packaging DATE RECEIVED: PAYMENT METHOD: Th St 9 May 2014 Application Deadline: 1 March 2014 PAYMENT DATE: AMOUNT CHARGED: £ FOR OFFICE USE ONLY General Certificate in Packaging DATE RECEIVED: PAYMENT METHOD: th st 9 May 2014 Application deadline: 1 March 2014 PAYMENT DATE: AMOUNT CHARGED: £ . Please read the notes in section 6 before completing this form. SECTION 1: PERSONAL DETAILS Title: Gender: MALE / FEMALE Date of Birth (06 Nov 1975): Forenames: Family Name: Membership no: Preferred Name: (optional) Company Name: Company Address: Home Address: I wish for my mail to be sent to my: HOME / COMPANY Academic Qualifications: Telephone No. (Include codes): E-mail Address: SECTION 2: EXAMINATIONS Syllabi and revision notes are included in the examination fee and will be forwarded to candidates by email, on receipt of application and payment. Applications received after 1 st November 2013 are subject to an additional £50 late fee per module. st Late applications will not be accepted unless received by 1 March 2014. GCB Examination £230 GCP Examination £230 Please select one of the following paper options: Please select one of the following paper options: Can Cask Beer Keg Chilled & Filtered Beer Non-Returnable Bottles Returnable Bottles Preferred Exam Centre: Preferred Exam Centre: SECTION 3: PAYMENT This section must be completed, applications will not be processed if payment details are left blank. Credit Card* Cheque/Bank Draft Purchase Order UK Debit Card (please enclose) PO Number: *subject to a 5% admin fee Contact Email: Type of Credit Card: VISA / MASTERCARD Personal/Company Card: Card Expiry Date: /20 Name on Card: 3 Digit Security Code: Card Number: SECTION 4: SPONSORS STATEMENT Every application should be supported by a mentor/sponsor. The mentor/sponsor must verify the qualifications and experience of the candidate and confirm that support will be provided. (Should you not have a clearly identifiable sponsor, please write NSA). Mentor/Sponsor’s Name: Relationship to candidate: Mentor/Sponsor’s Job Title: Sponsor’s IBD Membership No.: Mentor/Sponsor’s Address: Mentor/Sponsor’s Telephone no.: Mentor/Spon sor’s E Mail: Mentor/Sponsor’s Supporting Statement: (Short statement to confirm applicants experience and suitability) Signature: Date: SECTION 5: CONFIRMATION OF APPLICATION Print Name: Signature: Date: By signing I agree to abide by the IBD Examination Regulations SECTION 6: PLEASE READ CAREFULY 1. You must enter ALL of your details in Section 1 (unless shown as optional). 2. All applicants of the Diploma and Master Brewer Examinations MUST be members of the IBD. 3. Candidates are reminded that IBD Examinations are based on the contents of each syllabus. These will be issued to all candidates. 4. Please complete and return this form, together with your payment or PO number, to arrive before 1st November 2013. Candidates are reminded that they will not be registered until the application and payment or PO number have been received. All late applications are subject to an additional £50 late fee per MODULE. Late applications will not be accepted unless received by 1st March 2014. 5. No refund of examination or training fees will be offered. Deferrals for non-medical reasons will only be accepted up until 1st March 2014 and will incur a deferral fee of £75 per module. Deferral of fees will be granted on medical grounds on receipt of a medical certificate or doctor’s note. Fees may only be deferred once and requests must be made in writing. 6. Please contact us immediately if your personal details change or if you have any queries. All correspondence should be addressed to: Exams & Training Department The Institute of Brewing & Distilling 33 Clarges Street London W1J 7EE Tel: +44 (0) 20 7499 8144 Fax: +44 (0) 20 7499 1156 Email: [email protected] or [email protected] SECTION 8: EXAM CENTRES Please state your nearest town/city in Section 2 if you cannot find a centre local to you in the list below Centres available to all candidates : Samoa -Apia -Samoa Breweries Malaysia -Selangor -Napex Corp Angola-Luanda-Coca-Cola Bottling Luanda -- SAB Scotland-Aberfeldy-John Dewar & Sons Mongolia-Ulaanbaatar-Asia Pacific Breweries Australia-Adelaide SA-University of Adelaide Scotland-Aberlour-Speyside Community Centre Namibia-Windhoek-Namibia Breweries Australia-Albany WA-Great Southern Instit. of Tech Scotland-Edinburgh-Heriot Watt University New Zealand-Dunedin-Lion Nathan Australia-Brisbane QLD-Lion or QLD Univ. of Technology Scotland-Inverness-Inverness College UHI Nigeria-Ibadan-Nigerian Breweries Australia-Cairns QLD-James Cook University Scotland-Islay-Islay Learning Centre or Laphroaig Distillery South Africa-Durban-Diageo Global Supply Australia-Campbeltown-CUB Scotland-Orkney-Orkney College South Africa-Durban-NCP Alcohols Australia-Hobart-CUB Cascade Brewery Seychelles-Mahe-Ministry of Education St Lucia-Vieux Fort-Heineken Australia-Launceston-University of Tasmania South Africa-Cape Town-SAB Suriname-Paramaribo-Heineken Australia-Lidcombe NSW-Tooheys Pty Ltd (Lion) South Africa-Durban-British Council or SAB Tanzania-Dar es Salaam-Tanzania Breweries Limited Australia-Melbourne VIC-University of Melbourne South Africa-Johannesburg-SAB Thailand-Bangkok-Thai Asia Pacific Brewery Co Ltd Australia-Perth WA-Murdoch University South Africa-Port Elizabeth-SAB Trinidad-Champs Fleurs-Caribbean Development Co. Australia-Warnervale NSW-Carlton United Breweries South Africa-Pretoria-University of Pretoria Trinidad-Laventille-Angostura Australia-Yatala QLD-Fosters Sri Lanka-Colombo-British Council Uganda-Kampala-EABL Uganda Breweries Barbados-St Michael-Ministry of Education St Kitts-Basseterre-Ministry of Education Ukraine-Mykolaiv-AB InBev Yantar Brewery Belgium-Brussels-Boston University Sudan-Juba-Southern Sudan Beverages Ltd -- SAB USA-Albany GA-MillerCoors Botswana-Gaborone-British Council or SAB Miller Swaziland-Matsapha-Swaziland Beverages -- SAB USA-Albany NY-Horizon Milling LLC Brazil-Rio de Janeiro-Senai – Rio de Janeiro Sweden-Lillkyrka-Grythyttan Whisky USA-Anchorage AK-Broken Tooth Brewing Co. Burundi-Bujumbura-Brarudi (Heineken) Switzerland-Nyon-Open University Switzerland USA-Cincinnati OH-Samuel Adams Brewing Co Cameroun-Douala-Guinness Cameroun SA Tanzania-Dar Es Salaam-University of Dar es Salaam USA-Madison, WI-MBAA Brewery Packaging Course Canada-Calgary AB-University of Calgary Uganda-Jinja-Nile Breweries Limited – SAB USA-Portsmouth-Redhook Ale Brewery Canada-Charlottetown PEI-Holland College USA-Arcata CA-Humboldt State University USA-St Mary's PA-Straub Brewery Canada-Creston BC-College of the Rockies USA-Arkansas-University of Arkansas Vietnam-Binh Duong-SABMiller Canada-Halifax-Dalhousie University USA-Arlington TX-University of Texas Zimbabwe-Bulawayo-Delta Beverages -- SAB Canada-London ON-Fanshawe College USA-Boston MA-University of Massachusetts Boston Zimbabwe-Harare-Delta Beverages Canada-Niagara-on-the-Lake-Niagara College USA-Brevard NC-Blue Ridge Community College Canada-Ottawa-Academy of Learning USA-Chattanooga-University of Tennessee Centre may accept external candidates: Canada-Vancouver BC-Simon Fraser University USA-Davis CA-University of California Australia-Abbotsford VIC-Fosters Canada-Winnipeg MB-Canadian Malting Barley Tech Cen USA-Delaware-Delaware State University Australia-Bundaberg-Bundaberg Distilling Company Cayman Islands-Grand Cayman-University College USA-Florida-Florida International University Australia-Mildura-Mildura Brewery China-Shanghai-British Council USA-Fort Worth TX-MillerCoors Belgium-Leuven-AB InBev Denmark-Copenhagen-Scandinavian School of Brewing USA-Irwindale CA-Miller Coors Brazil-Joao Pessoa-Destilaria Tabu Dominica-Roseau-University of West Indies USA-Maryland-Frederick Community College Canada-Chambly Quebec-La Brasserie Unibroue Ecuador-Quito-British Embassy UKTI USA-Milwaukee WI-Miller Coors or University of Wisconsin Canada-Guelph ON-Sleeman Brewing Egypt-Alexandria-British Council USA-Minneapolis-St Catherine University NTRC Canada-Halifax NS-Labatt England-Blackburn-Daniel Thwaites USA-Missouri-Boulevard Brewing Co Canada-Montreal QC-Brasseurs de Montreal England-Burton on Trent-Molson Coors Brewers Ltd USA-New York NY-Cambridge Business Institute Canada-Montreal QC-MolsonCoors England-Hartlepool-Camerons Brewery USA-Norfolk VA-Old Dominion University Canada-St John's-MolsonCoors England-Hereford-Heineken or Wye Valley Brewery USA-Oregon-Oregon State University Canada-Toronto ON-Labatt Breweries England-London-IBD or UCL USA-Philadelphia-Temple University Canada-Toronto-MolsonCoors Canada England-Manchester-Heineken USA-Phoenix AZ-Phoenix College Canada-Toronto-Pure Spirits Distilling Corp England-Northampton-Carlsberg USA-Roanoke VA-Roanoke Higher Education Center Canada-Vancouver-MolsonCoors England-Ringwood-Ringwood Brewery USA-San Diego CA-White Labs Inc China-Yinjiang-Ab-InBev Zhedong Brewery Co. Ltd. England-Sheffield-Abbeydale Brewery USA-Trenton OH-MillerCoors Egypt-El Obour-Al Ahram Beverage Co. England-Stockport-Frederic Robinson USA-Utah Provo-Brigham Young University England-Alton-Coors Brewers England-Suffolk-Greene King USA-Virgin Islands-University of Virgin Islands England-Banbury-Hook Norton Brewery England-Tadcaster-Coors Brewers or Heineken USA-Washington-Western Washington University England-Bath-Bath Ales England-Wadebridge-Sharps Brewery USA-Windsor Vermont-Harpoon Brewery England-Cheshire-Thomas Hardy Brewery England-Witney-Wychwood Brewery USA-Woodinville WA-Craft Brewers Alliance England-Southwold-Adnams France-Lyon-CFPPA de Macon-Davaye Vietnam-Ho Chi Min City-British Council England-Thrupp-Stroud Brewery France-Paris-American University
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