Use this form if you are 18, or over 18, years of age. You must complete all sections of this form. For Cambridge English: Key, only complete this form if you want to use your result for immigration purposes and need a test day photo.
Candidate test day photo registration form Version 2 18 and over: Global 13/03/2013
Your details: First name(s):
Family name(s):
These names must be the same as the names on your passport/National Identity Card and must appear in the same order Date of birth:
(day/month/year)
Gender:
Male
Female
Email address: Phone number:
Mobile/cell phone number: City/town:
Address:
Post/zip code: Country:
This is the address that your certificate will be sent to. If you want your centre to send it to a different address, please contact the centre directly. Passport or national ID number: (this must be the ID you will bring with you on the exam day) Country of birth: Nationality:
Name of institution where you are doing a Cambridge English exam preparation course (leave blank if you are not doing a course):
Why are you taking the test?
For studying abroad For visa purposes For work
In which country? For which country? Other
Do you have any special requirements? For example, modified materials for visual difficulties, or special requirements because of a medical condition.
Candidate test day photo registration form Version 2 18 and over: Global 13/03/2013
Declaration: I understand that all individuals who want to take a Cambridge English exam are required to agree to all of the Terms and Conditions (a copy of which has been provided by the centre). I wish to be admitted for the selected Cambridge English exam at the centre listed on this form and for the date listed here. I will bring a valid photo ID with me on the test day, and I consent to have my photo taken by the centre on the day of the Speaking test and/or the written papers. I agree for this photo to be held on the secure Cambridge English Language Assessment Results Verification site and viewed as set out below if I give my agreement. Additionally, if I use my exam result for a visa/immigration application I agree for the exam result to be available on other sites shown at http://www.cambridgeenglish.org/cambridge-englishfor/visas-and-immigration/ if I give my consent. I hereby authorise the following to access my information (tick if appropriate): UKBA
The photo shall only be available to organisations/individuals that I give my details to or that I authorise to view my result. By signing this form I declare that I am aware of and agree to comply with the Terms and Conditions for this exam. Signature
Date
----------------------------------------------------------------------------------------------------------------------------------------For Centre Use Only
Exam Date: ....../..../.....
Test venue: ___________________________
Date of Payment:..../..../.....
Cost set in USD $: ____ / in VND: _________
Administrator’s initials: _____________
Amount received: ______________________
Candidate test day photo registration form Version 2 18 and over: Global 13/03/2013
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Post/zip code: Country: This is the address that your certificate will be sent to. If you want your centre to send it to a different address,. please contact the centre directly. Passport or national ID number: (this must be the ID you will bring wit
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