On Demand Private Candidate Entry Form 2005 - Pearson LCCI

8, Jalan Kerinchi, 59200, Kuala Lumpur, Malaysia. Tel: +603 2289 7000 Fax: +603 2289 7195 Email: [email protected] website: www.lcciasia.com. OP-REG-F1. Page 1 of 2. September On-Demand Exam - Private Candidate Entry Form. Closing Date : 15 August 2014. Personal Particulars (Please fill in ...
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September On-Demand Exam - Private Candidate Entry Form Closing Date : 15 August 2014 Personal Particulars (Please fill in BLOCK Letters) LCCI Centre code

CANDIDATE FULL NAME IN BLOCK LETTERS (as per National ID)

AMAL199A NRIC/Passport No. (attach photocopy)

Date of Birth (dd/mm/yyyy)

Nationality

Gender

Male

Female

Do you have any physical disabilities that may affect you in the examination? Yes/No (If yes please indicate) Postal address (Please ensure someone is available to receive the certificates)

Postcode

City

State

Email Address

Home/Office No.

Mobile Phone No.

Preferred exam location (town)

Please circle on the Subject Code

Level

Subject Code st (1 Diploma)

Subject Code nd (2 Diploma)

3

ASE3012

ASE3012

Accounting

3

ASE3902

ASE3902

Accounting (IAS)

3

ASE3003

ASE3003

Advanced Business Calculations

3

ASE3009

ASE3009

Business Statistics

3

ASE3017

ASE3017

Cost Accounting

3

ASE3024

ASE3024

Management Accounting

Subject Name

Exam Date & Time 24 September 2014 (0900 – 1200) 24 September 2014 (0900 – 1200) 22 September 2014 (1400 – 1700) 22 September 2014 (0900 – 1200) 23 September 2014 (0900 – 1200) 23 September 2014 (1400 – 1700)

Exam Fee (RM) RM209.00 RM209.00 RM209.00 RM209.00 RM209.00 RM209.00

Please make cheque payable to : LCCI INTERNATIONAL QUALIFICATIONS (M) SDN BHD Compulsory Postage Fees

RM15.00

TOTAL FEES PAID Important: Please select the correct Group Diploma Awards. st nd Please indicate “1“ for your 1 Diploma; “2“ for your Double Diploma (2 Diploma)

DIPACC07

-

Group Diploma in Accounting

DIPCOSTACC07

-

Group Diploma in Cost Accounting

DIPMANACC07

-

Group Diploma in Management Accounting

LCCI International Qualifications (Malaysia) Sdn Bhd Level 1, Tower 2A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200, Kuala Lumpur, Malaysia Tel: +603 2289 7000 Fax: +603 2289 7195 Email: [email protected] website: www.lcciasia.com OP-REG-F1

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IMPORTANT NOTE 1. Please ensure that the correct subject code is circled as NO amendment will be allowed after the Exam Entry Form has been submitted to LCCI Malaysia office. 2. A photocopy of the National Identity Card must be enclosed (COMPULSORY). 3. Please ensure that there will be a recipient (at the postal address) to acknowledge safe receipt of your results and certificates. 4. Please write the preferred state/town for the location of exam venue should the current address is different from your national ID. If the preferred state/town is not available in our list of exam venues, we will allocate to the next nearest state/town. (Note : Any changes after submission is NOT allowed) 5. Examination Docket will be mailed to the address provided in the Exam Entry Form approximately two weeks before the start of the examination. If you do not receive your exam docket at the period mentioned, please call LCCI Malaysia office for confirmation. 6. LCCI Malaysia reserves the right to cancel the exam if the exam cannot be held for any reason.

Payment Mode: ( Please tick √ ) Bank Draft or Banker’s Cheque payable to LCCI INTERNATIONAL QUALIFICATIONS (MALAYSIA) SDN BHD Direct Bank-in to LCCI Bank Account No: HSBC 359-131224-101 ** For Direct Bank-in to HSBC account, please submit the copy of “Bank-in Slip” together with your exam Registration form. Please write clearly your Na