2018-19

ENROLMENT FORM: UK NON-MEMBER COMPANIES

Please complete this form in BLOCK capitals

Student details: Company details:

Title (Mr, Mrs etc) Company name
Full name (as you would like it to appear on certificates)
Address

Email Phone

Occupation Mill Mentor details*:

Have you previously enrolled? Name
Student number (if known) Occupation
Email

Module Enrolment (includes 2019 exam registration) Please tick each course on which you wish to enrol
Module 1 Safety, Health and Hygiene
Module 2 Wheat and the Screenroom
Module 3 Mill Processes and Performance
Module 4 Product Handling, Storage and Distribution
Module 5 Flour
Module 6 Power and Automation
Module 7 Flour Milling Management

At which examination centre do you intend to write your

examination(s) in May 2019? *

Please e-mail info@nabim.org.uk if you need help identifying your

nearest centre.

NB: Students and their sponsoring companies are liable for any fees
charged locally by their examination centre.

COURSE FEES
£400 + vat per Module

Please note that if you choose not to enrol in a course but to register (on a separate form) only to re-sit the examination, the fee will
be £100 + vat per module. NB: You will not be able to register for the exam if you have never enrolled for the course.

I wish to enrol in the nabim course(s) shown above, and agree to allow information about my course performance to be passed to my
employer. Cheques should be made payable to nabim Ltd. A vat invoice will be sent on receipt of payment. If you wish to make
payment by BACS, you will be sent an invoice containing our account details.

Signature _______________________________ Purchase Order Number _______________________________

Date ____________________________________ Email for invoicing _____________________________________

Please tick this box if you consent to nabim sending student and/or mentor future Course Guides and other promotional
material related to this training programme.

* Each student must nominate a mill mentor and an exam centre in order for their enrolment to be completed.