Consent Form for Minors This Consent Form parts A and B must be completed by the test taker and the parent / guardian before the minor can take the test. A minor cannot complete test day check procedures without a signed copy of this form. This form must be brought and presented to the administrator on test day. Parents / Guardians seeking a chaperone opt out under section 2. Provisions below must submit this form to the Test Centre at least 7 calendar days before test date. (At the discretion of the test centre, opt-out forms may be accepted within 7 days of test date.) This form applies to all IELTS Speaking interviews. It also applies to special access arrangements for Writing, Reading or Listening when a test taker alone with a helper. A chaperone must be assigned in all cases except when a waiver is granted. See section 2. regarding waivers. Read sections 1. – 3. Complete parts A and B and submit the form to your Test Centre at least 7 days before the test date. 1. The test centre will provide a chaperone as required. Apart from the examiner or special access facilitator, only the chaperone will be allowed in the speaking room with the minor. 2. A parent/legal guardian who does not want the test taker to be accompanied by a chaperone on test day, can request a waiver if… • the test taker is at least 15 years of age on the test date. • the parent/guardian contacts the test centre in writing at least 7 calendar days before test date with A and B of this consent form completed. 3. Test Centre duty of care regarding the minor ends when the minor is returned to a responsible legal guardian after the test, or, in case a responsible legal guardian is absent, returned to the publicly accessible areas of the test location. IELTS is jointly owned by the British Council, IDP: IELTS Australia, and Cambridge English, part of Cambridge University Press & Assessment Page 1 of 2 IELTS.org A – For completion by Parent/Legal Guardian I have read, understood, and accept the conditions on this form. Full name (Parent or Legal Guardian) [Print in CAPITALS] Signature (Parent/ Legal Guardian) Signed: Date: Tick one box only. I consent for the test centre to arrange a chaperone for the test taker named in part B. The test taker meets the conditions in section 2. and I do not wish the test centre to arrange a chaperone for the test taker named in part B. Mobile number B - For completion by the IELTS test taker [Print in CAPITALS] Full name (Test Taker) Signature (Test Taker) Signed: Date: Age on test day ____ years and _____ months IELTS is jointly owned by the British Council, IDP: IELTS Australia, and Cambridge English, part of Cambridge University Press & Assessment Page 2 of 2 IELTS.org