Person in Charge – sales order form Please complete in black ink and block capitals. 1 Contact details 4 Credit card payment All credit cards EXCEPT American Express are accepted Type of card (e.g. VISA): Name on card: Card number: Name: Tel no: Email address: 2 Centre details Centre name: Centre number: Issue: Invoice address: Valid from date: / Valid to date: Security code: / (The security code is the last three digits of the number shown on the signature strip). Registered card address: 2 Delivery details Delivery address: 5 Payment total Please indicate your product selection on the list overleaf and state your total costs here: Shipment required by: (Shipment takes at least 3 working days to reach destination) Total order value (USD) Exam date (PIC): $ Exam venue: 3 Purchase order number Your ref: The CIEH is registered under the Data Protection Act. Information will not be passed to third parties. Prices_PIC_v1 11–11 Chadwick House Group Ltd (CHGL) is the trading arm of the CIEH, Registered Company no: 1999717 For internal use only Sales order number: Date: / / To complete your order please scan your completed order form and email it to us at [email protected] If you have any questions, please call us on 04 454 1241 Additional order forms can be downloaded from www.cieh.org/training Terms: Ref: CSMOF_PIC Person in Charge sales order form Please indicate your quantities in the table below PIC fees list Please complete in black ink and block capitals. Quantity Unit price USD Level 3 PIC examination paper (inc re-sit) $25.00 TOTAL Can be sold as a combination Level 3 PIC combination deal includes handbook and invigilation $46.00 Level 2 PIC Paper examination paper (inc re-sit) $19.00 Can be sold as a combination Level 2 PIC combination deal includes handbook and invigilation $40.00 PIC handbook (for level 2 and 3) $20.00 Can be sold as a combination PIC Invigilator fee $70.00 Plus $7 per candidate when there are more than ten people PIC re-mark $40.00 PIC replacement certificate $32.00 Please write your quanities above and fill in total costs in section 5 (overleaf) NOTES: Prices are valid from 1 July 2011 – 31 December 2012. This form should be sent to CIEH at least 28 days prior to the date of examination and any amendments should be confirmed in writing at least 28 days prior to the exam. Orders and amendments done within 28 days of the exam will be subject to an additional administration fee of $150 (USD). For security reasons all orders must be signed for on delivery.
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