ENTRY FORM

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Edexcel\IGCSE\Entryform\IGCSE Private May 2009..doc. L ... 4308. Arabic (First Language). ○ *. 1, 2. 4310. Art & Design : Fine Art. ○. X. 1. 4311. Art & Design : ...
HONG KONG EXAMINATIONS AND ASSESSMENT AUTHORITY

LONDON EXAMINATIONS IGCSE / GCSE EXAMINATION – MAY/JUNE 2009

FOR HKEAA USE

PRIVATE CANDIDATE ENTRY FORM

A

2

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Serial No. (11-14)

(You should read the “Notes for Persons Entering for the Examination” before completing this form) # Blacken as appropriate Full Name (BLOCK LETTERS) (leave one box empty between words) #

0 Mr

0 Ms

(35)

(16)

Surname

(36)

Other names

(65)

Postal Address (BLOCK LETTERS) (153) (66)

(95)

(96)

(125)

(126)

#0 H K

0K L N 0N T

(152)

Examination Centre (156)

Kowloon Side only

(155)

Contact Telephone No.: ............................................... Facsimile No.: ............................................................... E-mail Address: ............................................................ Name in Chinese (if applicable)

#

0 H.K. Identity Card No.

(157)

(167)

(

Sex

Date of Birth

(168)

(169)

1

) M/F

#

0 Other Identification Document

(174)

Day

Month

9

Year

If you do not have a HKID Card, please provide:

Name of Other Identification Documents (175)

(194)

Other Identification Document No. (195)

(214)

For registration by post or through a representative, a photocopy of the valid H.K.I.D. Card or the I.D. document should be sent with the entry form. WARNING - The entry of false or incorrect personal particulars in this form may render the candidate liable to prosecution under the Laws of Hong Kong. Edexcel\IGCSE\Entryform\IGCSE Private May 2009..doc

#

Blacken the circle against each subject entered

Paper No. in italic is coursework / practical

Syllabus Code (228)

New

Foundation Tier IGCSE Subject Name

4305 4308 4310 4311 4312 4313 4325 4330 4335 4340 4350 4355 4357 4360 4365 4370 4375 4380 4400 4420 4425 4437 4437 4437 4440

Accounting Arabic (First Language) Art & Design : Fine Art Art & Design : Textiles Art & Design : Photography Art & Design : Graphic Design Biology Business Studies Chemistry Commerce Economics English Language English as a Second Language English Literature French Geography German History Mathematics Physics Religious Studies Science (Double Award)

1666

GCSE Chinese (Cantonese)

Science (Double Award) Science (Double Award) Spanish

#

0 0 0 0 0 0

Option Code

Higher Tier

Paper No.

FA FA FA FA FA FA

#

0 0 0 0 0 0

1F, 3 1F, 3 1F, 3 1F, 3 1F, 3 1F, 3

Option Code

Single Tier

Paper No.

HA HA HA HA HA HA

FA

1F, 3

0

HA

2H, 3

0 0 0

FA F FA

1F, 3 1F, 2F 1F, 3

0 0 0

HA H HA

2H, 3 3H, 4H 2H, 3

FA

1F,2F,3F,7,8

FB

1F,2F,3F,7,9

FC

1F,2F,3F,8,9

Examination Fees No. of Subjects Entered

$

IGCSE Entries @ $ 2,045 (Science, Double Award)

$

IGCSE Entries @ $ 1,750 (Art & Design)

$

GCSE Chinese (Cantonese) Entries @ $ 1,005

$

(215 - 216)

0 0 0 0 0 0

* *

1 1, 2 1 1 1 1

0 0 0

*

1, 2 1, 2 1, 2

0

*

1, 2

0

A

1, 2

0

*

1, 2

0

A

1, 2, 3, 4

X X X X

Paper No.

HA

4H,5H,6H,7,8

HB

4H,5H,6H,7,9

HC

4H,5H,6H,8,9

A

*

Total Fees

IGCSE Entries @ $ 1,095 (except the following subjects )

Total Fees

0 0 0

Option Code

2H, 3 2H, 3 2H, 3 2H, 3 2H, 3 2H, 3

0

0 0 0

#

Private

Candidate

$ (217)

(221)

I agree to the conditions set forth in the “Notes for Persons Entering for the Examination” including the collection of personal data for the purposes stated.

Signature of Candidate

Date

INSTRUCTIONS Candidates are advised to consult the timetable and the Regulations and Syllabuses of the Awarding Body carefully before entering any subject so as to avoid subjects that clash on the timetable and prohibited combinations of subjects. No special arrangements will be made for such subjects.

FOR HKEAA USE ONLY Demand Note No.

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