Activities Training Assessment Certificate (ATAC) Enrolment Form

Please complete the details below print out the form and return by post with your remittance. Cheques should be made payable to 'Direct Care Publishing ' and sent to the address below.

Your training materials will be forwarded shortly and a copy of your enrolment form will be kept at the marking center.

NB. Even if your work is complete, you cannot receive your certificate unless you have completed and returned this enrolment form before your course work is submitted. 

  1. Please provide the following contact information:

    Name
    Title
    Organization
    Street Address
    Address (cont.)
    Town
    County
    Postal Code
    Country
    Work Phone
    Home Phone
    E-mail

  2. Please create your account information. This will be printed on your course. 

    User Name
    Password

  3. Dated: -- mm/dd/yy
    Signed:

 
Return this form to:
ATAC Enrolement, Incare Services, Commercial House, 19 Station Road, Bognor Regis, West Sussex, PO21 1QD.