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FCE Registration Form

1. Candidate Name

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2. Name of Exam

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3. Date of Exam

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4. Date of Birth

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5. ID Card or Passport
Number

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6. Mailing address

PHOTO stick here

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........................................................................
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7. Occupation

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8. Tel. Number .......................(home) .....................(office)...................(mobile).........................


9. Email Address

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Fax

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10. Have you ever taken Cambridge ESOL exams before? If Yes, please state the exams name(s)
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I certify that the information on this form is complete and accurate to the best of my knowledge.
I understand that I will be present on the examination day ....................... and bring my ID Card/Passport as my
identification evidence.
I will follow all Cambridge ESOL examination regulations as requested.

Signature of candidate ............................................................

Date ...........................

---------------------------------------------------------------------------------------------------------------------Organisers Use Only


Scheme: _____________

Examination:

_________________

Exam Date : ....../..../...

Receipt No.:

_________________

Date of Payment :..../..../...

Cost set in USS$: ____

Administrators initials

Amount received: _____________________________

Charging code: ________