Create Applicant Login

To apply for a login please fill in all information below. Required Fields

Applicant Information:
  Please note: If this is your first application for a Certificate of Qualification for use in both public and independent schools, please leave this space blank.
  Certificate Number:


Personal Information:
  Please note: Once your personal information has been saved, you can only change it in your application.
  Title:
  Surname:
  Given Name(s):
  Date of Birth:
  Gender:
  Birth Surname:
 
Phone Numbers:
  Home:
  Work:
  Mobile:
 
Primary Mailing Address:
  Address 1:
  Address 2:
  City:
  Country:
  Province:
  Postal Code:

Email:
  Email Address:
 
Confirm Email Address:
 
Login:
  Passwords must be between 6 and 12 characters long and contain at least one symbol and one number. e.g. abcd$2

  Password:
  Confirm Password:

Can't read security code?

Security Code

Please type the security code shown above: