Distance Learning Enrolment Form2

Distance

Learning Enrolment Form

PROGRAMME DETAILS: PROGRAMME TITLE: PROMO CODE: Start Date:

COURSE CODE: Course Fee:

PERSONAL DETAILS: Title: Surname/Family Name: MAILING ADDRESS FOR MODULES: Course material should be sent for the attention of: Building Street Number: Name: City/Tow Country n: : Telephone Number: APPROVING MANAGER: Title: Surname/Family Name: Telephone Number: BILLING ADDRESS: Building Number: City/Tow n:

Forenam e:

Postcode/ZI P: Email Address:

Forenam e: Email Address:

Street Name: Country :

PAYMENT DETAILS: PAYMENT OPTIONS: Credit Card : Bank Transfer: CREDIT CARD: Credit Card Expiry No: Date: CCV Number: (Last 3 digits on the back of the card, front of American Express): Cardholders Name: Cardholders Tel No:

Postcode/ZI P:

Cardholders Billing Address BANK TRANSFER: For payment by bank transfer (excl. US$ or HK$): Informa UK Ltd, Account 01825550, NatWest Bank, Colchester, Essex, UK. Sort Code: 60-06-06, SWIFT Address: NWBKGB2112B. Please send a copy of your transaction receipt and invoice number to the organiser on payment: fax: +44 (0)20 7017 5657 and ask your bank to include the reference ABOUT YOU: EMPLOYMENT DETAILS: Present Job Employment: Title: Employed Since: Building Street Name: Number: City/Tow Country: Postcode/ZI n: P: Telephone Email Number: Address: EDUCATION: (You may be asked to provide copies of all relevant certificates) Examinations passed and examinations taken which results are not yet known: Examining Body:

Yea r:

Lev el:

Subject Grade:

INDUSTRY EXPERIENCE: (Please enter details of industrial and professional experience or attached a resume)

PROFESSIONAL QUALIFICATIONS: (Please give details of any professional qualifications & name of professional body)

LAUNGUAGES: Mother Tongue: If English is not your mother tongue, please give details of any English language courses (eg: IELTS, TOEFL) that you have taken or details of how long you have been speaking English:

REFERENCES: (In the event a reference may be needed to support your enrolment, please give the name and address of one referee and his/her position: TRAINING MANAGER: If you are being sponsored by your company, please provide the name of your training manager or person responsible for training:

INVIGILATOR: (THIS IS MANDATORY) Please provide the name and contact details of the training manager/ manager acting as your validating examiner: SPECIAL NEEDS Do you have a physical or sensory handicap which might in some way affect your studies or may require specialist facilities or treatment.

PLEASE SELECT YOUR SPECIALIST MODULES For the programme you are taking, please select two specialist modules. CERTIFICATE IN MOBILE COMMUNICATIONS: A. Radio Systems B. Core Network Systems C. Business Processes D. Marketing, Branding & Services E. Billing & Mediation F. Network Implementation Basics

DIPLOMA IN MOBILE COMMUNICATIONS A. Advanced Radio B. Advanced Core Network C. Security & Fraud Prevention D. OSS/BSS & Billing Integration E. Marketing, Branding & Services F. Commercial, Aspects of Telecoms F. Commercial, Aspects of Telecoms

DIPLOMA BRIDGING/INTEGRATED CERT-DIPLOMA A. Business Processes in Telecoms B. Advanced Radio C. Advanced Core Network D. Security & Fraud Prevention E. OSS/BSS & Billing Integration F. Marketing, Branding & Services F. Advanced IP DIPLOMA IN 21ST CENTURY TELECOMMUNICATIONS: A. Access Network Technologies B. Core Network Technologies C. Converged Service Delivery D. Digital Television & IPTV E. Billing & Support for Converged Services F. Network Implementation - Basics G. Security H. Operating Effectively

DIPLOMA IN LTE & ADVANCED COMMUNICATIONS: A. LTE Radio Network Planning B. IP-based Core Network Dimensioning C. Service Delivery & IMS D. Traffic Engineering, QoS & MPLS in IP Networks E. Operating Effectively F. Marketing Next Generation Services G. WiMAX & other non-3GPP Access Technologies