AC Application Form

AGENCY

Authorized Agency CODE (if you own one)

SECTION 1 - Company / Organization Details - Please complete the following details in full

Company / Organization NAME

Registration Number

Legal Address

City

Post Code

Country

Operational Address - if different from the legal address

City

Post Code

Country

Company e-mail

Company website

QUALIFICATIONS WE WOULD LIKE TO BE ACCREDITED FOR

We would like to provide our students with the selected qualifications

How many students do you plan to train per year?

less than 200 students per year

more than 200 students per year

Write an indicative number of students you plan to train annually

Facilities you are using for your training activities

Our own offices

Offices rented when needed

Our own Class Room for theoretical lessons

Class Room for theoretical lessons rented when needed

Our own room with workstations with computers for conducting online theoretical exams

Room with workstations with computers for conducting online theoretical exams, rented when needed

Our own Shooting Range

Shooting Range rented when needed

SECTION 2 - Company / Organization's Director Details - Please complete the following details in full

Title

Mr.

Mrs.

Name

Surname

Date of Birthday

Passport Number or ID Card Number

Present Occupation

Home address

City

Post Code

Country

Home telephone number

Mobile phone number

Email address

SECTION 2 - Director Badge Details

SSCS Main Occupation Title (in the front of the badge)

Card Type

New

Renewal

Duplicate

Card Type

Operative

Instructor/Teacher

REQUESTED QUALIFICATIONS FOR OUR DIRECTOR:

Requested Qualifications for our Director

SECTION 3 - Shipping Address

Send Badges and Certificates to

Our Legal Address

Our Operational Address

I confirm all information provided is accurate and truthful in all respects. I accept and agree to all of terms and conditions of the scheme. Please visit www.sscs-scheme.com/terms-and-conditions.