<p> Higher Education Qualifications RE-ENTRY FORM (Candidates who were unsuccessful in the September 2012 session)</p><p>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.</p><p>Personal details: BCS Reference number: Surname/last name/family name:</p><p>First name/s:</p><p>Email address:</p><p>Mobile/contact number:</p><p>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)</p><p>Re-entry - Examination module/s (tick module/s below)</p><p>Certificate Diploma Professional Graduate Diploma</p><p>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)</p><p>UK International</p><p>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: </p><p>You can pay by cheque, credit card or debit card (please tick as appropriate). Cheque (please make cheques payable to BCS)</p><p>Credit/debit card*</p><p>*For security reasons to pay by credit/debit card please contact our Customer Service team on +44 (0) 1793 417424.</p><p>Confirmation to be signed by all candidates: (Please check all details carefully, as later amendments cannot be guaranteed)</p><p>I confirm that the information given on this form is correct </p><p>Signature:</p><p>Date:</p><p>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.</p><p>.</p><p>Re-entry form v0.1 July 2011 1/2</p>