2020 EXAMINATION REGISTRATION FORM: UK NON-MEMBER COMPANIES

NB: You do not need to complete this form if you have enrolled in the course for 2019-20.

Please complete this form in BLOCK capitals and submit it to nabim by no later than 28 February 2020.

Personal Details Company Details

Title (Mr, Ms etc) Company Name

Full name (as you would like it to appear on certificate) Address

Email

Your Occupation Mill Mentor

Student No. (if known) Email

Tel. No.

Module Exam Registration Please tick each exam for which you wish to register

You may register for a module examination only if you have and enter the last year you enrolled on the course.

previously enrolled on the course for that module. Exam Year last enrolled
Module 1 Safety, Health and Hygiene 101
Module 2 Wheat and the Screenroom 102
Module 3 Mill Processes and Performance 103
Module 4 Product Handling, Storage and Distribution 104
Module 5 Flour 105
Module 6 Power and Automation 106
Module 7 Flour Milling Management 107

At which examination centre do you intend to write your

examination(s) in 2020?

FEES
£100 + vat per student per exam
NB: Your examination centre may charge its own fee which you will be required to settle direclty with the centre.

I wish to register for the nabim examination(s) shown above, and agree to allow information about my exam performance to be
passed to my employer. Cheques should be made payable to nabim Ltd. If you wish to make payment by BACS, you will be
sent an invoice containing our account details; all transfer costs are to be covered by the payer.

Signature ____________________________ Purchase Order Number __________________________________

Date ________________________________ Email for invoicing _______________________________________

Please tick this box if you consent to nabim sending student and/or mentor future Course Guides and other promotional
material related to this training programme.