application

1. Page 1 of 2 CSWIP/10YR/2017
Application Form for CSWIP Ten Year Re-Certification (Overseas)
1. CERTIFICATE HOLDERS DETAILS
Name
House/Building name or number
Street/Road name
Town/City
Postal/Zip code
Country
CSWIP certificate number
Contact email
Contact telephone number
Date of Birth
2. FEES-
The Fee for processing this Assessment is £78.50 (Pounds Sterling)
Payment can be made
a) by Cheque/Demand Draft made payable to TWI Certification Ltd
b) by Credit/Debit Card - give details below. IMPORTANT: New legislation does not allow us to receive any card
details by email. If you send this application for review by email before posting the original, please do NOT
enter the Credit/Debit card details on this form before sending by email attachment - enter card details just
before posting or telephone +44(0)1223 899000 with the details. We thank you for your co-operation with
this. (Please note that any email received containing credit/debit card details in the body of the email or on
an attachment will be automatically deleted)
Credit/debitCard HoldersName
Card Number
Expiry Date Start Date
The Last 3 Digits of Securitycode on reverse of Card
c) by Bank Transfer using TWI Certification Ltd bank account details below -
Please ensure that when you are making a Bank Transfer that you pay all bank charges, ensuring that TWI
Certification Ltd receives exactly what is required from you.
Please also ensure that the Bank clearly gives:
Your Name, Your Certificate Number, Date the money was transferred
Bank name and
address
BARCLAYS BANK PLC, MARKET PLACE, SAFFRON WALDEN, ESSEX,
CB10 1HR, UNITED KINGDOM
Account number 60919349
IBAN number GB36 BARC 2074 0560 9193 49
Swift code BARC GB22
Branch Sort Code 20-74-05

2. Page 2 of 2 CSWIP/10YR/2017
PAYMENT BY COMPANY: If Paymentisbeingmade bya CompanyCheque orCreditCard then
please provide full companydetailsincludingcontactname andcompanyemail address withyour
application.
Company Name
Contact Name
Address
Telephone Number
Company Email
CHECKLIST FOR APPLICATION
All of the Itemsthat are listedin the Checklistbelowmust be producedfor your application to be
successful.Please tickthe Itemsthat you have enclosed.
Items Enclosed TICK
1. CandidatesDetails
2. Methodof Payment CreditCard Details Provided
Copy of Bank Transfer and state date
transfer was sent
Cheque/demanddraftenclosed.Payable
To: TWICertificationLtd in Pounds
Sterling
3. Log Sheets/ Book (Signedand stamped) by your employer(s)
In order to successfullyre-certifyyourCSWIPCertificate it isa requirement
that you provide at least 4 out of the last 5 years verifiedwork experience.
4. ContinuingProfessional DevelopmentForm
5. Record of Experience (Give details foryourcurrent or most recent employer)
6. An original document, givingresultsof an eyesighttesttaken within the last 2
years, confirmingthat you have taken a near visionsight test. Youroptician
must clearly state that your visionmeets one of the followingstandards:
Either aidedor un-aidedyou can read TimesRoman point size N5 or Jaeger
point size J1 at a distance of not lessthan 30cms.
For your convenience a form for this isattached.
7. The CSWIPCertificate that you are applyingto re-certify (Photocopiesofthis
certificate are accepted)
When complete please submit your application by post to:
TWI Certification Ltd, Granta Park, Great Abington, Cambridge, CB21 6AL, United Kingdom