IWCF Operations Limited

Accreditation Cancellation Request

Centre Details – Please complete the below details:

Centre Name:

IWCF Centre Number: Date:

Cancellation Centre  Administrator  Scheduler 

Type:
Classroom  Simulator  Practical Assessor  Instructor 
 Accreditation Cancellation Request

Instructions

It is the responsibility of the accredited centre to notify IWCF of any changes to the centre details - physical resources, management
resources and staff resources.

Please read the following information carefully and complete all required sections and submit to accreditation@iwcf.org.

The below table details the type of cancellation that can be made using this application form

Amendment Type Section – to be completed

Cancellation of Accredited Centre Section 1,2 & 9
Cancellation of Centre Administrator Section 1,3 & 9
Cancellation of Centre Scheduler Section 1,4 & 9
Cancellation of Room Section 1,5 & 9
Cancelation of Simulator Section 1,6 & 9
Cancellation of Practical Assessor Section 1,7 & 9
Cancellation of Instructor Section 1,8 & 9

Note: Once centre accreditation has been cancelled it cannot be re-activated. A new application for accreditation must be submitted.

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Printed copies are UNCONTROLLED: It is the user’s responsibility to verify printed material against the controlled document
 Accreditation Cancellation Request

1. Centre Details

Primary Centre Number

IWCF Membership Name:

Centre Name:

Address Line 1:

Address Line 2:

Town/City: County/State:

Postcode/Zip Code: Country:

Telephone Number: Fax Number:

2.Cancellation of Centre Accreditation 

Reason:

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 Accreditation Cancellation Request

3. Centre Administrator:
Name: Email Address: Cancellation Date

4. Centre Scheduler:
Name: Email Address: Cancellation Date

5. Cancellation of Room:
Room Reference Assessment Room Training Room Online Assessment Room
  
  

6. Cancellation of Simulator:
Room Reference Simulator Model Simulator Serial Number

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 Accreditation Cancellation Request

7. Practical Assessor:
Name Date of Birth Candidate Registration Number

8. Instructor:
Name Date of Birth Candidate Registration Number

9. Centre Declaration - to be signed by an authorised signatory

In signing this application form you are confirming that all requirements detailed within this application are correct.

Any personal data provided under this application form will be processed by IWCF in accordance with our Privacy Policy, a copy of which can be
requested from compliance@iwcf.org.

As an authorised officer of the above company I confirm that, to the best of my knowledge, the information given on this application form is correct.

Name: Position:

Signature: Date:

IWCF Use

Application
Signature: Date:
Reviewed by:
Application
Signature: Date:
Approved by:

June 2018 AC-0098 Version 2.0 Page 5 of 5

Printed copies are UNCONTROLLED: It is the user’s responsibility to verify printed material against the controlled document