Assessment Practising Certificate

Please Login/Register first before filling in this form otherwise the system will not recognise your contribution.

**Important information All Routes**

Before applying for an APC through this form you must have joined The Dyslexia Guild (MDG/FDG level) and submitted your qualification information for approval and membership.
You cannot proceed until this step has been completed.

Payment
Payment is by credit/debit card. If you require us to invoice your employer upfront you must first provide us with a Purchase Order by selecting the Pay Later* Option below on the form
*If you select the Pay Later option your application process will not start until all fees are paid in full (including Guild Membership Fee).

Once you have completed this registration and paid the relevant fee you will be sent a link to upload your documentation onto our Moodle site for assessor review.

Contribution Amount *

Renewal - £ 180.00

Route 1 (Qualification under 5 years old) - £ 180.00

Route 1 (Qualification over 5 years old) - £ 255.00

Route 2 (APEL route, plus 7 years experience) - £ 555.00

Total Amount

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

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Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Password

Confirm Password

Provide a password for the new account in both fields.

APC Personal Details + Payer Details

Please ensure your personal information is complete. If you are renewing your Guild membership or are applying for membership having taken one of our online courses, please log in before continuing. If you have lost your login details, use your email address to request a new password on using the 'Request New Password' option on the login page. If you have recently changed your email address, please contact APC Administrator via apc@dyslexiaaction.org.uk

Title *

First Name *

Middle Name

Last Name *

Previous Surnames

Date of Birth *

Gender *

Female Male Prefer not to say

Street Address *

Additional Address 1

Additional Address 2

Town/City *

Post Code *

Country

Email Address *

Telephone No *

Mobile Tel. No

Who will pay your contribution fee?

If some or all of your APC fee will be paid by a third party then please enter the contact details including Purchase Order Number, email, phone number and address (for invoicing purposes).

Third Party Payer Details

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

County *

Postal Code *

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Assessment Practising Certificate