IAT QCF Qualification REGISTRATION FORM 20_ _
CANDIDATE DETAILS
First Name
Surname
Any previous name
DOB
IAT Membership No. (if known)
ULN Number (if Known)
Home Post Code (UK Residences only)
Learning Disabilities
Male
Female
Evidence Provided
YES
NO
If yes please provide evidences.
Ethic Background: please tick a box
African
Black British
Mixed Black Caribbean
American
Black Caribbean
None
Asian
Black Other
Other
Asian Bangladeshi
Chinese
Salvic
Asian Indian
European
Undeclared
Asian Other
Mixed Other
White British
Asian Pakistani
Mixed White Asian
White Irish
Black African
Mixed Black African
White Other
Address (for Correspondence, we recommend you use a secure location)
Post Code
Tel. No.
Email
Please Note.
Areas that are shaded are mandatory fields; this information is required for the IAT to comply with UK
Learning Record Services (LRS) concerning data collection.
Incomplete forms will not be processed and will be returned.
The IAT will upload your completed qualifications to the LRS. If you do not wish this to be done please tick
box.
In some cases the IAT may have to carry out security background checks to authenticate the applicant. By
signing this form you give consent for this to happen. You will be informed if this is carried out.
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Employers DETAILS
Employer/Organisation
Supervisor Name
Email
Tel. No.
Employers Address
Section A
Registering for complete Qualifications.
Please tick the course you wish to enrol for.
IAT Level 2 Diploma in Laboratory Animal Husbandry QCF 600/0559/0
IAT Level 2 Diploma in Laboratory Animal Science and Technology QCF 600/0558/0
IAT Level 3 Diploma in Laboratory Animal Science and Technology QCF 600/0560/9
To enrol on the level 3 course, you will require to be studying or awarded the IAT Level 2 Diploma in
Laboratory Animal Science and Technology or equivalent qualification.
If you are claiming individual units exemptions please complete Exemption form
Section B
Centre / Course Provider registering with
Start date
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Data Protection Act 1998
All information contained in this form will be treated as strictly confidential.
By supplying information, you will also be indicating your consent to the information being processed for use in
administering the education process, and any moderation or quality control processes that are required.
It will be copied for use on the Institute’s database.
The information you supply may be used by the Institute to inform you of other carefully selected training/education
courses, or products and services that may interest you.
Please tick if you do NOT wish to be sent this information.
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Notes

Candidates will be expected to apply the unit theory to their work routines and practices.

Candidates are reminded that they must complete all assignments, achieving all of the learning outcomes and
grading criteria before they can be credited with the unit.

All work submitted must be the work of the candidate and researched by themselves.

The Institute reserves the right to fully investigate assessments where there is reason to believe a candidate
has engaged in plagiarism or collusion.

The full rules and conditions for the examination process and the relevant policy documents can be found on
the IAT website (www.iat.org.uk).
Candidate Full Printed Name_____________________________________________
(This name will appear on any certification)
Candidate Signature_________________________________
Centre Representative Name
Date_______________
_______________________________________
Centre Signature ________________________________
Date______________
(I have checked the information provided is correct and Exemptions applied for are genuine)
Moderators Signature
____________________________
Date______________
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