CONFIDENTIAL IELTS Appendix AMS 5 AMS IELTS Minor Candidate Consent Form Important — Please read this information careful before you complete this consent form. Your completed consent form ‘must be provided tothe Test Centre before or on the day of the Test. It must be provided before registration on fest day. if ‘you do not provide this Consent Form on or before the test day you will nt admitted to the test room. We recommend that ‘you keep a copy for your records. Who should use this form? ~ Any porson who wishes to take an IELTS test who has not yet reachod the age of lagal competence (i.,, is 2 minor under focal law). IELTS TERMS & CONDITIONS AND LEGAL NOTICES. Declaration 1. acknowledge thatthe IELTS tosis jointly owned by Birish Counc IELTS Australia Pty Ltd (ABN 84 008 64 766), whch is whol ovmned by IDP Education Lis (DP: IELTS Australia) and Cambridge English Language Assessment (part of te University of Cambyidge),calectvely refered to ste IELTS. ‘Test Parmer. 2. Lcerity thatthe information in my aplication form is complete, tus and accurate. 3, understand thatthe personal data in my application is colected for tho purposes ofthe IELTS tes. ard ‘consent fr this data to be disclosed to, processed and stored by the IELTS Tost Partners forthe purpose of such administration. | further consent for this eat including, without imitation, tst performance or score data and my test result to be isclosed by the IELTS Test Parners to those Recognising Organisations to which | apply and to governments (including visa processing authorities Such as UKVI) forthe purpose of alowing these ‘organisations to verity my test result orto carry out enquiries in relation to suspected malpractice. the IELTS Test Parmer discover that false or allored “Test Report Form has been provided to any ofthese Recognising Organisations or government authortis'I further consent thatthe IELTS Test Partners may inform te same and provide them with ny personal data anc any relevant deals rlaing to the work | produce as part of my test taking, including, without imation, test perrmance or seore da 4. understand that my personal data may be processed in an anonyrus form by the IELTS Tost Partners for statistical and research purposes, The IELTS Test Partners ang the cones administering the test confirm tat they wll not disclose personal information about candidates to ahers excopt as stated in tis Declaration oro the extent permed by law. 5, understand that | may view a copy of my personal data contained in my apptcation by contacting lsts@eamordosenalish ora | uncerstand that a fee willbe charged for access to ths information. 6, Lundorstand that, il want a copy of my finger scan, it can only be provided as a Binary Large Object, Apil2015 eaition eS0Nel Sxidp 10. 12, 13, IELTS for UKVE: Administrators Manual Supplement (BLOB) and the request must be made to ‘ells@icp com or els@loriisheounci.org. Lndersland a fee wil be charged fr access to this, information understand that, the details on this form are not completed, my application may not be procossed. | further understand that completing and submiting this application does not quarantee registration on in preferred test date or al my prefer test location. I understand that my registration wil be Confirmed within 24 hour, alga understang tha | wil bs contacted in the event that atest date cannot be made availabe to mo within 28 daye of placing my application. understand that any personal data collected ‘uring the identity verification process by the centre either at test registration or on test day wil be processed and securely stored by the IELTS Test Partners for the purpase ofthe IELTS test. | acknowledge that the photograpi(s) taken of me by the centre will be provided to any Recognising Organisations or government authorites (including visa processing authorities) to which | apply for the purposes of allowing these organisations to verity ‘iy tost results or to carry out enquiries in relation to possioie malpractice or test integrity issues. | Understand that where finger-scan data is. ‘obiained it will not be discioses to any entity except the IELTS Tost Partners. Lnderstané that | will have my photographs) taken by the test centre to allow the Test Report Form tobe released, If| have not had my photograph taken by the test centre no result will be issued. | acknowledge that | have read the IELTS Notice lo Gandidates and agree lo abide by the rules and regulations contained therein, | understand there may be local terms and conditions | must comply with and that the test Centre wil provide detais of these on request, | understand that | must attend all four test Components in order to receive an IELTS test result and that any exception to this must be ‘approved in advance by the centre. | understand thatthe IELTS Test Partners have a ‘Section AMS Page 23, CAMRRINGE ENGHISHCONFIDENTIAL AMS responsibly to all candidates and Recognising 16, | understand that if any other person attempts to Organisations to ensure the highest confidence in take the IELTS test in my place, both | and such the accuracy and integrity of test results and that person will be liable to prosecution. Detals the IELTS Tost Partners therefore reserve the relating to the situation may be provided to the Fight to withhold test results temporary oF rolevant authoriles, including visa processing permanent, o to cancel test results which have futhorites and appropriate regulaory authorties. been issued, if they consider those results to be Lnreiabe for reasons of suspected malpractice or any other regularity in the test process. 17. understand thatthe work | produce i the IELTS. test remains the property of te IELTS Test Partners. It wil not bo released to candidates orto 14, L understand that my result may not be issued 13 insttutions or organisations, except in the days after the IELTS test if the IELTS Test investigation of suspected malpractice, in which Partners deem it necessary to review any matter cease, my work may be provided to relevant associated with my test or he administration of my authorites, test, including making enquires as to whether any rules or regulations have been breached. | Understand that, before my results can be issued, | may be required to provide additional samples of my witing and speaking for the purposes of assisting any investigation before or after the test. | understand that, in exceptional circumstances, may be required to re-ake one or more IELTS 418, l understand that there willbe video recording and components. CCTV (Clased Cireut TV) inthe Test cente. | ‘agree to be videoed while | am in the test centre fon the test day, including from the place where | register and in each ofthe test rooms used for leach part of the test | take. | understand that video recordings will be used for mantoring purposes, Investigations into suspected malpractice and fenquires on resuls, | understand ido not agree to be video recorded | will not be able to take the 18. | understand that my IELTS Speaking test wil be ‘audio and video recorded. | understand that in the ‘event that the test does not record, | wil be required to retake the speaking test. | also agree that an observer may attend my IELTS Speaking test as part ofthe monitoring process, 15. | understand that if |am suspected of engaging in any form of malpractice, or do anything that might damage the integrity and security of IELTS, I may not receive a test result, my tost feo will not be refunded and | may be prohibited from taking the IELTS test inthe future, Despite and without limiting any ofthe terms ofthis Declaration, | Understand that details of any malpractice {including evidence of suspected malpractice) that test has been established, s suspected ors beng 20. | understand tat | wil be charged the fl test oo formaly Investigated may be provided to ifeance! my test or request transfer within five Recognising Organsatios,incuaing visa wooks ofthe tat dat, unless | provide processing authoriies and appropiate regulatory appropriate medical evidence, within fv days of Buthriies, or otherwfse disclosed In accordance the test date, o support ihe cancelation or wth tela, where required for verfeation transer uses cnet puposesio oie eIELTS 5. 1 acknowledge thal have ead to IELTS tmalpractice. I futher understand that suspected Information for Candidates (avs) ‘malpractice will be reported centrally tothe IELTS Test Partners and to any relevant Test Centre by the centre where the suspected malpractice occurred Consent, Full name of Candidate Signature Dat (if you are minor, please ask your parent/legal guardian to read all information provided and sign the consent below.) | declare that | exercise parental care of the candidate named on this form and I have read, understood and accept the above. Full Name of Parent/ Legal Guardian Signature Date @O BRITISH CAMBRIDGE ENGLISH S820 Ridp ae