STREET WORKS QUALIFICATIONS REGISTER (SWQR) RE-REGISTRATION / REPLACEMENT CARD (SWQR 2) APPLICATION FORM RE-REGISTER CARD (not available in England) Working in: Scotland Wales 2 OR REPLACEMENT CARD OR N. Ireland TRAINING CENTRES ONLY SWQR Approved Centre Number Purchase Order Number (if required) CANDIDATE DETAILS – Please complete all information in BLOCK CAPS PHOTO Existing SWQR Registration Number (if known): PLEASE ATTACH WITH GLUE ONLY Title: Forename(s): Surname: Date of Birth: / / (DD/MM/YYYY) ADDRESS WHERE CARD IS TO BE SENT: Address to: Line 1: Line 2: Town: Post code: Phone / Email: MAIL CHECK LIST – For office use ONLY SWQR EXPIRY DATE PO CHECKED DATA CHECKED I the undersigned hereby certify that the above candidate details have been completed accurately. Please note that all information given will be taken as precise by SWQR and no liability will be held for inaccurate information. SIGNATURE PRINT NAME DATE FEES & PAYMENT (Valid until March 2016) I enclose a cheque/ postal order made payable to ‘SWQR’ I wish to pay by credit/ debit card Receipt Required (optional) Card Details (Amex, Solo & Electron cards are not accepted): Visa Mastercard Disclaimer: If you wish to pay via card, SWQR will accept no liability if your card details are lost in the post. Maestro Visa Debit Re-registration (max 3 months after card expiry date): Replacement Card: Card Number Valid From Expiry Date Issue No. Security No. £20.35 £20.35 GUIDANCE NOTES TO ASSIST WITH THE COMPLETION OF SWQR APPLICATION FORM Please follow the guidance notes carefully. Applications that have been incorrectly completed will be returned. Applications may be delayed if there is a mistake on the form, the necessary fee has not been enclosed, or the photograph sent in does not meet our guidance note requirements. Complete the form in CAPITAL LETTERS. Please write only within the space provided. The I/D card will have a digital image of the applicant’s photo. Please tick the relevant box beside the type of application you are making and which country you will be working in – Re-registration is not applicable if you are working in England 1. TRAINING CENTRE DETAILS If centre is to be invoiced, as per prior agreement, please supply your SWQR Approved Centre number along with a Purchase Order number (if required). If purchase order numbers are required by your centre, but not completed, applications will be returned. We will not complete purchase order information on behalf of a centre. 2. CANDIDATE DETAILS Please supply the candidate’s existing SWQR Registration Number (if known). Please complete the candidate’s full name, including title and date of birth. Attach a current passport size photograph of the candidate (see separate guidance leaflet on acceptable photographs). Please use glue, and do not staple the photograph. 3. ADDRESS WHERE CARD IS TO BE SENT Please fill in the address details, including company name and who the card should be addressed to, if applicable. Complete a contact telephone number and/or email address; this will only be used in the event of a problem with the application. NB The I/D card will be returned to this address. Please ensure that this address is correct. Covering letters/compliment slips etc. will not be accepted as a notification of address Please read the declaration, sign and print name and date the form accordingly 4. FEES AND PAYMENT Payment can be made by cheque/postal order (in UK pounds sterling only) or by credit/debit card. Please make cheques/postal orders payable to ‘SWQR’. If paying by credit/debit card, please complete all required fields. Please note that Amex and Solo cards are not accepted. Re-registration – if your card is due to expire in the next 3 months, please pay the Re-registration fee. - If your card has expired you must Re-register before your card has expired more than 3 months. - If card has expired more than 3 months you cannot re-register and must fully retake your qualifications. If you require a receipt for your payment please tick the box. This is optional so if the box is not ticked a receipt will not be issued. NOTES Where possible, the existing I/D card should be returned to the SWQR with the completed application. RETURN FORMS TO: The Street Works Qualifications Register (SWQR) The Optima Building 58 Robertson Street GLASGOW G2 8DQ Telephone: 0345 270 2720 Email: swqr@sqa.org.uk Website: www.swqr.org.uk