Candidates are advised to apply for BHS
Membership at least 6 weeks before submitting an exam application. Membership subs may accompany an exam application but please allow extra time for processing.
If you have applied for Membership but have not received your number, you may still apply for an exam - please state the date you applied for membership, method of payment and whether your application was made by post, telephone or over the internet. Please return this form with fee to:
The Education Department,
BHS, Abbey Park, Stareton,
Kenilworth, Warwickshire, CV8 2XZ
Tel: 02476 840508 Fax: 02476 840501

FOR OFFICE USE ONLY:

CENTRE:
DATE:
CENTRE:
DATE:
CENTRE:
DATE:

BHS MEMBERSHIP NUMBER :
Date of Expiry :
MR / MRS / MS / MISS / OTHER

STAGE 2

SURNAME

Maiden Name

FIRST NAMES IN FULL

APPLICATION FORM
PERMANENT ADDRESS

EXAM REQUIRED (tick box)

BHS STAGE 2
CARE

Postcode

Tel:

OTHER ADDRESS (To which any correspondence should be sent)

RIDING
Tel:
UNITS ONLY

Date of Birth

(tick relevant boxes on form attached)

Height

Weight

Unique Learner No
(if applicable)

Date and Centre required:

Fee Enclosed:

£
2nd Choice:
3rd Choice:
4th Choice:

Receipt
Required YES/NO

Date Received:
CREDIT/DEBIT CARD (Give details inc. expiry date, security code and issue no. or valid from date, where applicable)
INVOICE
CHQ.
P.O.
CASH
From:

Please refer to the "Exam Bookings - Terms and Conditions" section on the reverse of this application form.
Especially with regards to cancelling or transferring exam dates.
All personal information including examinations results and qualifications will be held in accordance with the
Data Protection Act of 1998. Data may be released to the Regulatory Authorities and to government departments and agencies, prospective employers, training providers and educational establishments.
THIS FORM MUST BE SIGNED: This is to certify that I take the