Indian Testing Board

Examination Registration Form

Name of Candidate

Telephone

Email

ITB Exam (Check One)

Foundation
Advanced
Form of Fee Payment:
Attached Check
Draft (for Indian Testing Board Payable at
NOIDA)
Not Applicable (Company Pre-paid)

Dates of Course (if any)

Date of Exam/Centre

Name of Training Course (if any)

Name of Training Company (if any)
Name of Training Instructor (if any)

Send results and certificate to (address):

Signature

________________________________

Date __________________

This form should be submitted with the completed exam, along with payment.
FOR PROCTOR USE ONLY
Proctor Name __________________________
Date of exam __________________________
Results
Points: ________ out of ________ total, ____ %.

I, ______________________, administered

o Fail

this test to __________________________

o Pass

o Pass with distinction (>80%)

Candidate informed of result: o Yes o No

on _____________, and graded this test on

If no, reason: ___________________________

________________, with the results shown.

______________________________________

Signature _____ ______________________

FOR OFFICE USE ONLY

Results sent to candidate: o Yes o No

Received by __________________________

If no, reason: ________________________

Date of exam __________________________

Certificate sent to candidate: o Yes o No

If no, reason: ________________________