8/11/2019 (253732308) IELTS Application Form
1/8
NOT FOR SALE
Application form
please attach a recent
passport-sized
photograph here securely
(Note: thephotograph
must not be more
than 6 months old)
please attach a second
identical signed
passport-sized
photograph here using a
paper clip
PLEASE WRITE IN BLOCK CAPITALS
1 Preferred date of test
2 Family name
3 Title (Dr/Mr/Mrs/
4 Other name(s
(these names m!st "e the same as the names on yo!r
passport/National #dentity $ard
and m!st appear in the same order%
5 Address& please note yo! 'ill only "e sent one copy of
yo!r res!lts% Please ens!re the correct mailin address is
i)en* since yo!r res!lts 'ill "e sent to this address%
6 Telephone/Mo"ile n!m"er
7 email
8 Date of "irth 9 +ender F M (circle as appropriate
10 Please indicate 'hich doc!ment yo! 'ill "e !sin as proof of
identity and i)e the n!m"er "elo'%
$andidates ta,in the test o!tside their o'n co!ntry m!st present
a c!rrent passport or National #dentity $ard%
-o! m!st "rin the #D doc!ment indicated "elo' to the test% This
is the only form of identity that 'ill "e accepted
on the test day% The doc!ment m!st "e )alid/not e.pired at
reistration and on the test day%
Passport National #dentity $ard
Passport or National #dentity $ard n!m"er
For office !se only
scheme test date d d m m y y
date of payment
d d m m y y receipt n!m"er
#D chec,ed Administrators initials
A$ +TPlease turn over 0
Please ret!rn to&
($entre stamp
d d m m y y second choice d d m m y y
Miss/Ms
d d m m y y
8/11/2019 (253732308) IELTS Application Form
3/8
This notice has "een 'ritten to help yo!%
Read it caref!lly and do as yo! are
as,ed% #f there is anythin yo! do not
Notice to #ELTS $andidates!nderstand* as, the #ELTS
Administrator
or the e.amination s!per)isor%
Disquai!i"a#i$% &a'%i%(#f yo! are ca!ht infrinin any of the
candidate r!les and re!lations yo!r test res!lt 'ill
"e dis1!alified and notification sent to any recei)in
instit!tion or professional "ody%
R!les and Re!lations
You must You must not
D Pro)ide proof of yo!r identity (e%% passport or national D
#mpersonate another person or ha)e another
person identity card at reistration and e)ery e.amination
session% impersonate yo!%
Second co!ntry nationals m!st prod!ce a passport% This #DD
Attempt to cheat* copy the 'or, of another candidate or
m!st contain a n!m"er* a sinat!re* a date of "irth and a disr!pt
the test%photoraph%
D :se* or attempt to !se* a dictionary* paer* spellchec,er*D
Pro)ide t'o recent identical passportsied photoraphs electronic
recorder or mo"ile phone for the d!ration of the
on reistration% test% Any candidate doin so 'ill "e
dis1!alified%
D Only ha)e on yo!r des, yo!r identification* a pen/pencil andD
Tal, to or dist!r" other candidates once the
e.aminationan eraser% has started%
D Ens!re mo"ile phones* paers and any other electronicD Smo,e*
eat or drin, in the e.amination
room% de)ices are s'itched off and placed 'ith personalD
Reprod!ce any part of the test in any format/medi!m%
"elonins o!tside the test room%Any candidate doin so 'ill ha)e
their test res!lts
Any candidate 'ho does not s'itch off their
phone/paer*dis1!alified and "e lia"le to prosec!tion%or 'ho retains
one in their possession* 'ill "e dis1!alified%
D Remo)e any materials !sed d!rin the e.amination%D Notify the
test in)iilator immediately if test day conditions in
This incl!des* "!t is not limited to* e.aminationpapers* any 'ay
impede yo!r performance% spea,in tas, cards* ans'er papers and
'or,in paper%
Ad)ice and information D Read caref!lly and follo' the
instr!ctions printed on the1!estion paper and on the ans'er
sheet%
Ma,e s!re yo! attend on timeD Fill in the details re1!ired on
the front of yo!r 1!estion
D ;no' the date* time and place of yo!r e.amination and paper
and on yo!r ans'er sheet "efore the start of thearri)e "efore the
sched!led startin time%
e.amination%D #f yo! arri)e late for any of the papers* report
to the
s!per)isor or in)iilator% -o! may not "e allo'ed to ta,e Ad)ice
and assistance d!rin the e.amination
the e.amination% D #f yo! are in do!"t a"o!t 'hat yo! sho!ld do*
raise yo!r
hand to attract attention% An in)iilator 'ill come to yo!r
Pro)ide 'hat yo! need assistance%
D Ta,e into the e.amination room only the pens* pencils andD -o!
may not as, for* and 'ill not "e i)en* any
e.planation erasers 'hich yo! need for the e.amination% of the
1!estions%
D $orrection fl!id and hihlihters m!st not "e !sed%D #f on the
day of the e.amination yo! feel that yo!r 'or, may
D Lea)e anythin 'hich yo! do not need* or 'hich is not "e
affected "y ill health or any other reason* yo! m!st
inform allo'ed* o!tside the e.amination room% the in)iilator at
the time%
D -o! may not lend anythin to* or "orro' anythin from*Lea)in the
e.amination room
another candidate d!rin the e.amination%D -o! may not lea)e the
e.amination room 'itho!t the
D Do not "rin )al!a"les as the test centre cannot "e permission
of the s!per)isor or in)iilator%responsi"le for these%
D -o! can not lea)e yo!r seat !ntil all papers ha)e "een
E.amination instr!ctions collected and yo! ha)e "een told yo!
can lea)e%
D Listen to the s!per)isor and do 'hat yo! are as,ed to do% D
6hen yo! lea)e the e.amination room yo! m!st lea)e "ehind
D Tell the s!per)isor or in)iilator at once any paper !sed for
ro!h 'or, clearly crossed thro!h and
2 if yo! thin, yo! ha)e not "een i)en the riht any other
materials pro)ided for the e.amination%
1!estion paper% D Do not ma,e any noise near the e.amination
room%
2 if the 1!estion paper is incomplete or illei"le%
Res!lts D #n e.ceptional circ!mstances* res!lts may "e delayed
andyo! may "e re1!ired to reta,e one or more mod!les 'here
D
Res!lts are iss!ed "y test centres* !s!ally 05 days afterthe
pattern of mod!le res!lts is hihly !n!s!al%
the test%D Please note that instit!tions and oranisations yo!
ha)e listed
D Res!lts may "e delayed or 'ithheld 'here any of the R!les
!nder 1!estion 43 may access yo!r res!lts "efore yo!
ha)e and Re!lations ha)e "een "reached% recei)ed them "y
mail%
#mportant& please detach this section (paes i2i) and retain
for yo!r o'n records% i
