UNIT 2A, KILNAP BUSINESS & TECHNOLOGY PARK, OLD MALLOW ROAD, CORK CITY, IRELAND
Tel: +353 (0)21-4909700, Fax: +353 (0)21-4308364
Email: enquiries@ipics.ie, Web: http://www.ipics.ie
APICS CSCP PAPER-AND-PENCIL EXAM
REGISTRATION FORM
APICS ID Number (required)
First NAME
Last NAME
Date Of Birth
Month
Day
Year
(If Work Address is
being used)
Company Name
Preferred address:
Home
Work
ADDRESS:
Phone
Fax
Email
Exam Date
Preferred
Exam Centre
Month
Day
Year
Please see page 2 for cancellation and deferral deadlines
Please return with your cheque for €675 (member) /€725 (non-member) made payable to IPICS, at Unit 2a, Kilnap Business &
Technology Park, Old Mallow Road, Cork City, Ireland, Tel: 021-4909700, Fax: 021-4308364
Or please debit my  VISA
 MASTERCARD
Name (as it appears on card):
Account Number:
Authorisation Code:
Expiry Date:
 LASERCARD Account
(please  tick)
_____________________________________________
(Please see back of credit card, 3 digit number after the card number.)
Signed: ____________________________
Date: ________________________
Please note the closing date for receipt of Registrations.
Company Limited by Guarantee. Registered office: IPICS The Supply Chain Management Institute
Unit 2A, Kilnap Business & Technology Park, Old Mallow Road, Cork, Ireland. Registration No. 87310
Associate of APICS - Association for Operations Management (USA)
Member of the European Logistics Association (ELA) (Brussels)
UNIT 2A, KILNAP BUSINESS & TECHNOLOGY PARK, OLD MALLOW ROAD, CORK CITY, IRELAND
Tel: +353 (0)21-4909700, Fax: +353 (0)21-4308364
Email: enquiries@ipics.ie, Web: http://www.ipics.ie
CPIM/CSCP EXAMINATIONS DEADLINES AND FEES:
RE-SCHEDULING DEADLINE
In order to re-schedule or defer an exam a written request must be sent to IPICS, no
later than 35 working days before the exam date. Re-schedules or deferrals will not be
accepted after this date. Any candidate who chooses to reschedule or defer an exam
can only defer to the next sitting. (I.e. Deferral or re-schedule from March to June, or
June to December etc.)
CANCELLATION DEADLINE
In order to cancel an exam a written request must be sent to IPICS, no later than 35
working days before the exam date. Cancellations will incur a cancellation charge of
€50.00 for CPIM examinations and €200.00 for CSCP examinations. Cancellations
within 10 working days before the exam will not be accepted and will forfeit the entire
exam fee.
MEDICAL CANCELLATION DEADLINE
Medical cancellations will be accepted no later than 10 days after the exam date. Any
candidates who cancel on medical grounds must provide a medical certificate or will
forfeit the entire exam fee.
Please see the CPIM Exam Registration Procedures and CSCP Exam Registration
Procedures on our website www.ipics.ie
Company Limited by Guarantee. Registered office: IPICS The Supply Chain Management Institute
Unit 2A, Kilnap Business & Technology Park, Old Mallow Road, Cork, Ireland. Registration No. 87310
Associate of APICS - Association for Operations Management (USA)
Member of the European Logistics Association (ELA) (Brussels)