Preparation – Form 3

Modified Question Papers

Please complete the relevant sections of this form and return it to Info@cambridgeinternational.org. Please include your centre number, exam series
and ‘Modified Question Paper’ in the email subject line. To avoid potential delays in processing your modified paper request, please do not send access
arrangement and modified question paper requests in the same email.

You must submit final entries and applications for modified question papers by the deadline. If we receive final entries and applications after the
deadline, we cannot guarantee that we will be able to supply the modified question papers you need.

The deadlines for requesting modified question papers are:

May test series (checkpoint) October test series

Form and June exam series (Checkpoint) and
application deadline November exam series
application deadline
Group 2: Modified Modified Papers: 21 January 2020 1 July 2020
question papers Preparation - Form 3

I confirm, as Head of Centre or Exams Officer, that our centre will ensure the integrity of Cambridge International exams is upheld and that we hold
appropriate evidence of need to support these modified question papers. I understand that failure to keep to Cambridge International regulations could
be considered malpractice.

Centre number Centre name

Name Exam series Please select

Job title Please select Date

Other Signature

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 Preparation – Form 3

Modified Question Papers

You must apply for any modified question papers required by completing the relevant boxes below. Centre number

Candidate number Candidate name

Standard Modification
Syllabus number Syllabus title Component number Type of modified question paper required Coloured paper

If you are requesting modified materials for any speaking tests/oral exams, use the boxes below to notify us of when you plan to conduct the test
within the relevant testing window.

Syllabus Component Test date Test day

number number
Click to add new Preparation - Form 3

This is an interactive PDF. To complete it on screen we recommend you use Adobe Reader 9 or later or Adobe Acrobat. You can download
Adobe Reader for free at http://www.adobe.com/products/reader.html
If you use an earlier version of Adobe Reader you data will not be saved.