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									                                                                                                                Candidate Entry Form
                                                                                  Cambridge ESOL Examinations: Winter 2009



Please note: Write in CAPITAL LETTERS only. Date of birth should be written in the format DD/MM/YYYY.


CANDIDATE INFORMATION

  Name
  Surname                                                                                                     Gender                      Male                  Female

  Date of birth

  Street                                                                                                                             Street No

  Post code                                                                         Town

  Landline phone                                                                    Mobile phone

  Email
  School*

*This field is optional: If you took your exam course in a school and want to receive information through them, please write
down the school name in this field.
TICK THE EXAMINATION YOU WILL TAKE

     YLE Starters                   KET                                   CAE                           BEC Preliminary                             TKT module 1
     YLE Movers                     KET for Schools                       CPE                           BEC Vantage                                 TKT module 2
     YLE Flyers                     PET                                   ILEC                          BEC Higher                                  TKT module 3
                                    PET for Schools                       ICFE                                                                      TKT KAL
                                    FCE                                                                                                             TKT CLIL

I WANT TO SIT* THE EXAMINATION IN:

    Belgrade                     Novi Sad                       Subotica                     Sombor                         Niš                     Podgorica (MNE)
*Please note that the examination session will be held in the city of your choice only if there is a sufficient number of registered candidates.

DECLARATION

I DECLARE THAT
1. I have received all relevant information relating to the Cambridge examinations, 2. I have read the Exam Regulations and agree to the conditions stated
therein, 3. I agree to my personal data being processed for purposes related to the administration of the Cambridge ESOL exams in accordance with the Data
Protection Act, 4. My personal data stated above is correct.

FOR THIRD PARTIES AUTHORISED TO REGISTER A CANDIDATE:

1. I have received and read all relevant information relating to the Cambridge examinations (including Exam Regulations) and will pass it on to the person I
have registered for the exam if that is the case, 2. The candidate agrees to his/her personal data being processed for purposes related to the administration of
the Cambridge exams in accordance with the Data Protection Act 3. The candidate's personal data stated above is correct.


If you want to receive further updates in the form of emails, e-newsletters, SMS reminders and other
information about British Council examinations and related activities, please tick this box:  I agree


Signature                                                                                Date:



PRINT Signature


To be completed by British Council Montenegro                                            CHECKED AND CONFIRMED BY:
CANDIDATE NUMBER: EA          /
PAYMENT SLIP NUMBER:



             The United Kingdom’s international organisation for educational opportunities and cultural relations. We are registered in England as a charity.

								
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