Study for a Chartered Institute of Purchasing & Supply (CIPS) qualification by Distance Learning through MCG

Credit Card Form Request

Title Bold indicates a required field.
First name Your given name
Surname /Last Name /Family name
Date of Birth / /


Postal Code/ Zip Code Enter 0000 if not applicable
Email Please ensure valid email      
Alternative Email Re-enter email above if alternative not available   
Highest qualification held
Current Job Title 
Years of work experience
Programme Applied
Payment Method
[Please indicate subject(s)  for which you may have applied for exemption]
CIPS Membership Number
[Enter 000 if not issued]


If all the details are correct press the 'Submit' button. If you wish to change anything please do so before submitting, or press the Reset button.

(Please email should there be a problem in submitting the form)