Application to register for the AEA Certificate (England/Wales)

Name: AEA Annual Conference 2019
Start: 2019-02-03T15:30:00+00:00
End: 2019-02-06T11:30:00+00:00

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Personal Details
Title*
Surname*
Forenames*
Home Address
Date of Birth*
Home Telephone Number*
Office Telephone Number*
Home Email Address*
Office Email Address*
AEA Membership Number*
Academic Qualifications
Degree or similar level
Professional/Vocational qualifications
Secondary Education
Current Employment
Employer*
Department*
Post Title
Date appointed to present post
Description of present duties
Eligibility
A candidate is not able to register for the Certificate unless he/she can either demonstrate a minimum of three years' work experience in both electoral registration and elections administration or have registered for and completed/will complete the Foundation course in that year or a previous year. Please tick the appropriate box below to indicate which of these two options apply to you.
Foundation course or three years' work experience*
- I attended the Foundation course in the year(s) detailed below and completed/will complete all five modules
- I have completed a minimum of three years' work experience in both electoral registration and elections administration
Please tick one box only and, if you have ticked the 3 years experience box, provide the relevant information in the next but one section, headed 'Previous Job Experience'.
Year(s) that you attended the Foundation Course, if applicable
Previous Job Experience (you only need to complete this section if you ticked the 3 years' experience box above)
List your previous posts in electoral registration/elections in chronological order starting with the most recent (prior to your present post). Please list Authority, Job Title, Dates and Main Duties for each post
Please detail in the relevant boxes below any areas of the syllabus in either module where you have NO relevant work experience:
C1 - Registration of Electors
C2 - Elections Administration
Fees
Fees to be invoiced
Tick the items required (one MUST be 'Registration').
- Registration (£642)
- Assignments (four) (£135 each)
- Examinations (£179 each)
Total Amount to be invoiced
£ 0.00
Purchase Order Number (if appropriate):
Council Supporter
Name*
Position*
Council*
Telephone Number*
Statement by Applicant
I certify that the information given in this application is true. I confirm that I have read the Rules relating to the Qualification and that I understand that I am responsible for:

(a) compliance with the Rules;
(b) preparing for the Qualification under my own arrangements;
(c) undertaking such preparation and study which is required;
(d) being and remaining a member of the AEA.

I also confirm that I have the support of my Council to undertake this Qualification. I have provided the details of my Council supporter above.

I hereby apply to register for the Certificate in Electoral Administration.
Notes to Applicant
1. You will be invoiced for the course elements that you have indicated above. This must include at least the registration fee. All fees are subject to VAT
2. This form must be received by the Association by no later than 1st September
3. If you have any queries about the completion of this form, please email AEAQualifications@sunderland.gov.uk

Personal Details

Academic Qualifications

Current Employment

Eligibility

Fees

Council Supporter

Statement by Applicant

Notes to Applicant