Online Application for Replacement Certificate

REASON FOR REPLACEMENT CERTIFICATE

Please chose the reasons for replacement certificate to be issued choosing from below -

Select your reason*

Details of other reason*

PERSONAL DETAILS OF LEARNER

Please provide your personal information as appeared on your passport or other official ID

Title (Mr/Miss/Dr etc.)*

First name(s)*

Surname/family name*

Previous surname*

Sex*

Male
Female

Nationality*

Ethnicity*

Date of birth*

Country of birth*

Country of permanent residence*

You must provide us with at least one proof of your identity choosing from below to justify your request for replacement certificate : -*

Birth certificate
Driving Licence
Passport

f the reason for your request is due to change of name, please also include al least one prrof of evidence choosing from below to justify your request : -*

Marriage certificate
Decree Absolute
Deed Poll

If your name has changed as a result of gender re-assignment, please also include one form of evidence choosing from below*

Letter from your medical practitioner (such as your GP)
Deed Poll Record

CONTACT DETAILS

Please provide us with your contact details

Mobile (including country and area code)*

Home Phone No (including country and area code)*

Work Phone No (including country and area code)*

Fax*

Email Address*

Contact address*

Permanent address (if different from contact address)*

YOUR REGISTRATION DETAILS WITH EBMA

Please provide us with your registration details with EBMA

Qualification Title*

EBMA registration Number (If known)*

PAYMENT DETAILS

You agree that EBMA will process your application only after payment (£100/replacement certificate) is received.

Please pay either by
Bank Transfer
To: 'Education for Business Managers and Administrators Ltd'
             Reference:   EBMA Registration Number/R
                      Bank:   Lloyds Bank
   Account Number:   58126668
             Sort Code:    30-64-42

OR by
Cheque payable to 'Education for Business Managers and Administrators Ltd'

Consent*

I agree*

CHECKLIST

The request for replacement certificate will not be processed until we have received all the relevant information. Please ensure you provide us with the following documents:-

Evidence of £100 fee paid for single replacement certificate*

Proof of learners’ identification*

Proof of learners’ identification in case of change of name*

Enclosed the original certificate if your request is based on the any reason except it has been stolen or lost*

DECLARATION

You must confirm that the information provided in this application is true and accurate to the best of your knowledge.

Declaration by you

I declare that the above information and all appropriate documentation attached with this application are true to the best of my knowledge. I am aware of that EBMA reserves the right to not to issue replacement certificate on the reasonable ground in the case of false/not true or incomplete information. I further acknowledge that I have read and understood and agreed to adhere to the procedures and policies in respect of this application.

I agree*

Apply for Replacement Certificate

Online Application for Replacement Certificate