Certificate/Diploma/Advanced Diploma in Insurance Accelerating ...
Certificate/Diploma/Advanced Diploma in Insurance Accelerating ...
Certificate/Diploma/Advanced Diploma in Insurance Accelerating ...
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Once you have read the notes on complet<strong>in</strong>g your application, you can either:<br />
• complete and submit your application onl<strong>in</strong>e at www.cii.co.uk/qualifications<br />
• phone through your order to Customer Service on +44 (0)20 8989 8464 ensur<strong>in</strong>g<br />
that you have your credit/debit card details ready<br />
• complete the form below and post or fax +44 (0)20 8530 3052 to Customer Service.<br />
<strong>Certificate</strong>/<strong>Diploma</strong>/<strong>Advanced</strong><br />
<strong>Diploma</strong> <strong>in</strong> <strong>Insurance</strong><br />
Application form<br />
Important note: To ensure that your application is processed correctly please enter your name at the top of each page <strong>in</strong> the space provided.<br />
ICI005 (11/12)<br />
Section A – Personal details (Please complete all fields. Your name should be entered as you wish it to appear on all official CII documents.)<br />
Have you ever had previous contact with the CII? Yes No (Please tick)<br />
Please give your CII/PFS permanent identity number (PIN) if known PIN<br />
Mr/Mrs/Miss/ Surname<br />
Ms/Other<br />
Forenames<br />
Employer’s name<br />
Gender Male Female (Please tick) Date of birth<br />
email*<br />
Work address<br />
Tel Ext Mobile<br />
Postcode Country<br />
Home address<br />
Postcode Country<br />
* Please take care when provid<strong>in</strong>g your email address as most correspondence will be sent electronically. Email address must be <strong>in</strong>cluded when order<strong>in</strong>g<br />
ebooks or LEARN.<br />
Tick address to be used for postal correspondence Home Work<br />
Please tick one box per category<br />
Type of organisation<br />
Bank/Build<strong>in</strong>g Society Broker/Intermediary Consultancy <strong>Insurance</strong> company Legal<br />
Lloyd’s Loss adjuster/Loss assessor Re<strong>in</strong>surance company/broker Other<br />
Area of work<br />
Adm<strong>in</strong>istration/Process<strong>in</strong>g Brok<strong>in</strong>g Claims/Loss adjust<strong>in</strong>g Compliance F<strong>in</strong>ance<br />
HR/Tra<strong>in</strong><strong>in</strong>g Risk management/Survey<strong>in</strong>g Sales/Market<strong>in</strong>g Underwrit<strong>in</strong>g Other<br />
Job category<br />
Board member<br />
(CEO, Director)<br />
Study path<br />
Where you are study<strong>in</strong>g <strong>in</strong> order to complete a qualification please <strong>in</strong>dicate by tick<strong>in</strong>g the appropriate box:<br />
Award <strong>in</strong> London Market <strong>Insurance</strong><br />
Bus<strong>in</strong>ess owner<br />
Middle management<br />
(Branch, Office, Dept)<br />
Technician/Co-ord<strong>in</strong>ator Tra<strong>in</strong>ee Other<br />
Area(s) of specialism<br />
(Commercial)<br />
<strong>Certificate</strong> <strong>in</strong> <strong>Insurance</strong><br />
<strong>Diploma</strong> <strong>in</strong> <strong>Insurance</strong> <strong>Advanced</strong> <strong>Diploma</strong> <strong>in</strong> <strong>Insurance</strong><br />
Senior management<br />
(General, Head of) Supervisory/Controller<br />
Accident and health Aviation Construction Eng<strong>in</strong>eer<strong>in</strong>g Liability<br />
Mar<strong>in</strong>e Motor Property Travel Other<br />
(Personal)<br />
Accident and health Home Motor Pecuniary loss Travel<br />
Other<br />
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