To have a TOEIC Official Score Certificate sent to an institution, supply all ... I
authorize the IIBC Test Operation Center to release my Official TOEIC Score ...
TOEIC® Official Score Direct Reporting Service Request Form 【NOTES】 To have a TOEIC Official Score Certificate sent to an institution, supply all requested information and send the completed form with a postal money order for ¥1000 (tax included) per institution. All the information must be given or the form will be returned to you. Scores more than two years old cannot be reported or verified. Within four business days of receiving your application, we will send TOEIC Official Score Certificates to your designated institution by registered mail or by parcel delivery service. Holidays including Saturdays, Sundays, national holidays, and year-end through New Year's holidays are not counted as business days.
Applicant information Name
※The name printed on your TOEIC Official Score Certificate cannot be changed for any reason including legal name changes.
Month:
Date of birth
Day:
Year:
〒 Address, current The confirmation letter from the IIBC Test Operation Center will be sent to this address after your request form has been accepted.
Telephone number, daytime
TOEIC test administration information ｔｈ TOEIC test
Administration number and date
Month:
Day:
Year:
The administration number of your TOEIC test is required. Incomplete request forms will not be accepted.
Registration (or Application) number
〒 Address and telephone number, on day of TOEIC test （TEL）
Institution information Name of the institution 〒 Address of the institution
I authorize the IIBC Test Operation Center to release my Official TOEIC Score Certificate to the institutions designated above, under the terms and conditions of the Official TOEIC Score Direct Reporting Service Guidelines and Request Form. Date：
/ Month
/ Day
Signature： Year
【Send documents to】 The Institute for International Business Communication IIBC Test Operation Center TOEIC Score Direct Reporting Service Sanno Grand Building, 2-14-2, Nagata-cho, Chiyoda-ku, Tokyo 100-8957 TEL: 03-5521-6033 10:00 - 17:00 (Excluding Saturdays, Sundays, public holidays and the year-end through New Year holidays.) 2014 年 1 月版 ETS, the ETS logo, PROPELL, TOEIC, TOEIC Bridge, TOEIC BRIDGE are registered trademarks of Educational Testing Service in the United States, Japan and other countries and used under license.
