Date of payment: _ _ / _ _ /2012 (dd/mm/yyyy). ID checked ... Please remember to
bring the following with you on the day of the Cambridge English: First (FCE):.
Cambridge ESOL FCE Registration Form
Test date: _ _ / _ _ /20_ _ Please attach a recent passport-sized photograph here securely (Note: the photograph must not be more than six months old)
Family name: ______________________________ Title: (Please circle) Mr. / Miss / Mrs / Ms First name: ________________________________ Address: __________________________________ __________________________________ __________________________________ __________________________________ Telephone / Mobile number: ____________________________________ E-mail: ______________________________________________________ Date of birth: _ _ /_ _ / _ _ _ _
(dd/mm/yyyy)
Please indicate which document you will be using as proof of identity and give the number below. N.B: Candidates taking the test outside their own country must present a current passport. You must bring the ID indicated below to the test. This is the only form of identity that will be accepted on the test day. The document must be valid/not expired at registration and on the test day. (Tick one of the two boxes)
Passport
National ID Card
Passport or National ID Card number: For office use only Date of payment: _ _ / _ _ /2012 (dd/mm/yyyy)
ID checked
Receipt number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Speaking Test date: _ _ /_ _ / 2012
Administrator’s initials:
Page | 1
Time: _ _ _ _ _
Candidate number: _ _ _ _ _ _ _ _ _
Country or region of origin: ________________________ First language: __________________________________ Occupation: ____________________________________ Why are you taking the test? (Please circle) A For work B Your studies C Immigration purposes D Other (Please specify _______________________________________________________ ) Have you ever taken one of the Cambridge ESOL exams before? (Tick one of the two boxes below) Yes
No
N.B: If your answer is “Yes”: Which of the following Cambridge ESOL Exams have you taken? (Please tick) KET
PET
BEC P
KET for Schools
BEC V
YLE (Starters)
PET for Schools
FCE
CAE
BEC H YLE (Movers)
YLE (Flyers)
When did you take this exam? _ _ / _ _ / _ _ _ _ (dd/mm/yyyy) Where did you take this exam? __________________________________________________ Have you attended an FCE Preparation Course?
Yes
No
N.B: If your Answer is “Yes”, where was it? (Please tick) at Language Solutions Algeria in other School
(Please specify _________________________________________)
What level of education have you completed? (Please tick) Secondary up to 16
secondary 16 – 19 years
degree or equivalent
How many years have you been studying English? (Please tick) 1 (less than)
Page | 2
2
3
4
5
6
7
8
9 (or more)
post-graduate
Do you have any special requirements due to ill health/medical conditions? (Please tick)
Yes
No
If your answer is “Yes”, please specify your requirements below. You must attach supporting medical evidence to this form. Requests for modified materials must be submitted at least three (03) months before the test. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
Page | 3
IMPORTANT INFORMATION 1.
On the Test Day
Please be present at the test venue one (01) hour before the start of your exam for instructions and ID checks. If you are more than 10 minutes late after the start of the test, you will not be permitted to take the test and you will lose the whole exam fee. Please remember to bring the following with you on the day of the Cambridge English: First (FCE): Your fee receipt; Your original Passport or National ID or driving licence; Pens, pencils, pencil sharpener and eraser as required Please note that you must bring the same ID you used to register for the Cambridge English: First (FCE) If you fail to bring the same ID indicated in your application form, you will not be able to sit for the test; you will not be reimbursed the test fee. Copies of Passport or National ID or driving licence will not be accepted. Please do not bring any valuables to the test venue. On arrival at the test venue, you will be asked to leave all your belongings in a separate room or at the back of the exam room. If it is in a separate room, then this will be securely locked. However, we ask you not to bring any valuables on the test day. Mobile phones are not allowed to be taken into the test room. Your mobile phone will be put in an envelope with your name on it and put into a transparent plastic box. You will have to sign when putting your mobile phone into the box and also when collecting it after the speaking test. You are only allowed to take the following items into the test room: your passport or national ID; Pens, pencils, pencil sharpener and an eraser in a transparent plastic bag. N.B: Language Solutions Algeria is not responsible for any loss.
2.
Results
Your results will be released online on the date mentioned on your Confirmation of Entry letter sent to you by e-mail before the exam day. On the test day you will be able to indicate if you would like to collect Certificate in person or if you would like it to be sent to you by courier (free of charge) to your personal address within Algeria. There is an additional fee if you would like it to be couriered overseas. You can also authorise someone to collect your Certificate on your behalf. In this case, you will need to write a signed letter giving this person’s name and passport/ID number. The person must bring the mentioned ID and a copy of your Passport/National ID. Please note if you lose your Certificate we cannot give you another copy.
Page | 4
3.
Refund Policy (Transfers & Cancellations)
If you wish to transfer to another available test date (can only be done once) or cancel your test, you must inform us before the closing date. Please ask the reception to know what the closing date is. For transfers, you will need to pay an administration fee of 2,000 DA. For cancellations, you will receive the registration fee minus a cancellation fee of 2,000 DA Any candidate wishing to transfer or cancel a test after the closing date is not entitled to any refund and will lose the entire test fee. If you have any queries regarding your forthcoming Cambridge English: First (FCE) or would like information about our preparation courses, please feel free to contact the school. Finally, on behalf of everyone here at Language Solutions Algeria, I wish you the best of luck in your forthcoming exam.
DECLARATION I hereby confirm that I have read and understood the “important information” section and that the information I have provided on this application form is accurate.
Candidate’s signature
Date
Page | 5
_ _ / _ _ / 20_ _
