QUALIFICATIONS APPLICATION FORM

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QUALIFICATIONS APPLICATION FORM Please return application form to: qualifications@pensions-pmi.org.uk All candidates please complete the information below PMI Membership Number (if previously a member): Date of Birth: Title: First Name: Surname: Job Title: Home Address: (including postcode) Employer Name: Work Address: (including postcode) Daytime Phone Number: Mobile Phone Number: Email address: Please complete the information below ONLY if you are applying for student membership for the first time: Communication preferences Address you would like to be used for correspondence (PMI News etc.) Home Work Do you wish to receive communication from the PMI Regional Groups: Yes No If yes, please select the Regional Group(s) you wish to be contacted by: Eastern London Midlands North East North West Scotland Southern South West Important Information Membership of the PMI is on an individual basis and is non-transferable The membership year runs from 1 September to 31 August (with the exception of Affiliate Membership which runs from 1 November to 31 October and Trustee Group Membership which runs from 1 January to 31 December) The current membership subscription fees due can be found on our website Data Protection The PMI is registered under the Data Protection Act and maintains a membership database to: enable information to be exchanged as required between you, the PMI, its subsidiaries, qualification centres and individuals involved in assessment and regional groups, relevant regulators, and employers; administer any examinations or qualifications you enter and courses you undertake or events you attend; administer billing and accounts; distribute publications and information about other PMI services; distribute mailings from 3rd parties which it believes may be of interest; confirm your membership status and PMI qualifications. If you do not wish to receive mailings about future PMI events and services please tick here or from 3rd parties please tick here. You can change these preferences later. Declaration I hereby apply for membership of the Pensions Management Institute and declare that all the information given in this form is correct and that I consent to it being held in accordance with the Data Protection and Privacy Statement. I hereby undertake, if admitted to the Pensions Management Institute duly to observe the Articles of Association, Code of Professional Conduct, Rules and Regulations for the time being in force for the duration of my membership. The Code of Professional Conduct and other relevant documents are published on the PMI website. Signed: Date:

PMI Entry Form September/October 2018 The form and payment must be received by the PMI by Friday 13 July 2018 PMI Membership Number (if a member): Qualifications you are studying for: Retirement Provision Certificate (RPC) Certificate in DC Governance Award in Pension Trusteeship (APT) Please tick Title: First Name: Surname: Email address: Daytime Phone Number: Please tick the relevant package/examination you wish to apply for. Examination Date Examination/Study Material Package* Examination Re-Sit Fee** Revision Course*** Member Price New Member Retirement Provision Certificate (UK Candidates only) Wednesday 12 September 2.30pm - 4.30pm 385 460 180 160 Retirement Provision Certificate (Overseas Candidates only) TBC 535 610 330 Certificate in DC Governance) Wednesday 12 September 2.30pm - 4.00pm 385 460 180 160 Award in Pension Trusteeship Wednesday 12 September 2.30pm - 4.00pm 225 225 See website for courses TOTAL FEE Please tick your first choice examination venue: Birmingham Bristol Edinburgh Leeds London Manchester If you are an overseas candidate, please state your location: If you are sitting at an Approved PMI Centre, please state your company name and centre code: If you are not already a member of the PMI, please make sure you have completed all of the details on the first page of the form to set up your affiliate/trustee group membership. Please note applications will not be processed until payment has been received. On receipt of payment, applications will be processed within a maximum of 10 working days. Please complete a Payment Form to accompany your application. Please note we do not defer any examinations. * Package price includes examination entry and study material, EXCEPT for APT, which does not have any study material. ** Does not include membership fees *** Revision Course dates will be published on the PMI website. APT has external training events full details can be found on our website. I can confirm I have read the 2018 Examination Regulations: Signed: Date: FOR OFFICE USE ONLY Date Application Received Date Entered Date Payment Received Payer Invoice Number Date Payment Processed

PAYMENT FORM Name PMI Member Number Payment Details Payment in respect of: Amount TOTAL Payment made by: Company (if so please state) Individual Payment has been made by: I enclose a cheque made payable to PMI OR I would like to pay by credit / debit card, details are: Type of card (please tick) Mastercard Visa Debit Card Switch Maestro Amex Card Number Start Date / End Date / 3 Digit Security Code (4 digit for Amex only) Name on Card Signature OR I would like to pay by BACS, details are: Account Name PMI bank account details: HSBC Bank plc, 100 Old Broad Street, London EC2N 1BG Sort code: 40-07-31 Account number: 61146203 (Expected) Date payment made Please ensure your surname, PMI member number or invoice number is given as a reference on the BACS payment. FOR OFFICE USE ONLY PMI Member Number PMI Company Number Amount Date Received C

Certificate in Pensions Automatic Enrolment Retirement Provision Certificate (UK entries only) i Certificate in DC Governance Award in Pension Trusteeship EXAMINATION REGULATIONS REGULATIONS: It is a condition of acceptance of an examination entry that the candidate has carefully read these regulations (ticking the appropriate box on the entry form as confirmation) and agrees to abide by them 1. EXAMINATION ENTRY: Candidates are responsible for ensuring that they complete the appropriate Examination Entry Form and return it by the published closing date for entries. The form is available on the PMI website and can be posted or e-mailed details are on the form. Please note, once you have registered for a qualification it cannot be transferred to another person. The address given on the Examination Entry Form must be your normal correspondence address. This address will be used for all examination correspondence. A candidate who has changed address must indicate this clearly so that the Institute s records can be updated. In order that the Institute can deal promptly with any queries that arise concerning the examinations, candidates must give their daytime telephone number wherever possible. This number must be updated should it change at any time before the examinations are completed. Please supply a valid and correct email address. Acknowledgements and your admission permit will be sent via this method. If your email needs updating please confirm this to the PMI as soon as possible. Any enquiry concerning examination entry after the form has been submitted must quote the PIN Member number. 2. FINAL ENTRY DATE AND ACKNOWLEDGEMENT: The last date for entry for the examinations is shown on the entry form and the PMI website. UNDER NO CIRCUMSTANCES CAN ENTRIES BE ACCEPTED AFTER THIS DATE. All entries will be acknowledged. Any candidate who does not receive an acknowledgement within a reasonable time should contact the Institute before the closing date for acceptance of entries and while there is still time for another entry to be submitted if the original has gone astray in the post. Candidates are advised to check their acknowledgements carefully. 3. FEES AND REMITTANCES: Examination entry fees are detailed on the entry form and website. Payment can be made by cheque, BACS or credit card. Cheques should be made payable to The Pensions Management Institute and must accompany the Examination Entry Form. Further details regarding BACS or credit card payments can be Registered at the above address. Registered with limited liability No 01262100 in England

found on the entry form. In either case both the payment and the original entry form must be received by the closing date for entries. A receipt for examination fees is not an acknowledgement of acceptance or entry. 4. WITHDRAWAL FROM EXAMINATIONS:.Examination entry fee packages for RPC, CPAE and DC Governance qualifications includes access to the on-line study material, the examination, the certificate for all those who pass and in some cases Affiliate membership of PMI. Therefore, the withdrawal rates shown here have taken this into consideration. Should a candidate decide to withdraw from the examination they must submit their request in writing no later than two weeks prior to the examination date they will receive 50% of the examination resit fee. After that date there is no refund and the candidate will be marked as absent from the examination. Candidates who withdraw for medical reasons have until the examination date to notify the PMI. 50% of the examination resit fee will be refunded on receipt of a doctor s certificate. APT candidates: should a candidate decide to withdraw from the examination they must submit their request in writing no later than two weeks prior to the examination date and they will receive 50% of the examination fee. After that date there is no refund and the candidate will be marked as absent from the examination. Candidates who withdraw for medical reasons have until the examination date to notify the PMI. 50% of the examination fee will be refunded on receipt of a doctor s certificate. 5. SPECIAL CIRCUMSTANCES: At the discretion of PMI special arrangements can be made for candidates for reasons of illness, disability or similar. Applications under this regulation MUST be made in writing and supported with medical evidence, at the point of entering the examination but no later than 6 weeks before the date of the examination. Applications after that time period will only be considered in the case of sudden illness or accidental injury (again, only if supported with medical evidence). 6. EXAMINATION VENUES: A list of the current examination venues can be found on the PMI website and they are listed on the examination entry form. Candidates should note that examination venues may change from session to session. Whilst every effort is made to provide a venue that is as central as possible in or to the centre town or city the Institute cannot always guarantee this. Alternatively, candidates can sit their exams at their place of work IF that is an approved centre Candidates should note that it is NOT possible under any circumstances to change their choice of centre. 7. EXAMINATION ADMISSION PERMITS: The Examination Admission Permits will be emailed to candidates approximately two weeks before the examinations are due to begin and this will confirm the address the candidate needs to go to in order to sit the examination. Candidates must check that details are correct on this form and contact PMI if there is any doubt. Registered at the above address. Registered with limited liability No 01262100 in England

8. PHOTO IDENTIFICATION: All candidates will be required to bring appropriate photo identification to the examination venue. You will be required to produce this identification for the examination invigilator before the examination begins. If you do not comply with this requirement you will not be permitted to sit the examination. 9. CONDUCT OF THE EXAMINATIONS: The conduct of the examinations is under the control of The Pensions Management Institute. All candidates must submit in all matters to the directions and rulings of the PMI invigilator in the examination rooms. LIABILITY: If the Institute, for reasons outside its control, should find it impossible to hold any of its scheduled examinations, or if a candidate s completed script should be lost or destroyed, the Institute's liability shall be limited to a complete refund of the examination fee paid in respect of the examination concerned. 10. RESULTS: (a) (b) The decision of the Examiners Committee is in every case final. Requests for confirmation or reconsideration of the results should be directed to the Qualifications Department at PMI House. The examination results will be sent to candidates as soon as they are available. The Institute reserves the right to publish examination results, whether successes or failures. www.pensions-pmi.org.uk qualifications@pensions-pmi.org.uk i NOTE all RPC Overseas candidates will sit their examinations in April and follow the same regulations as for the Advanced Diploma in Retirement Provision. Registered at the above address. Registered with limited liability No 01262100 in England