EXAMINATION REGISTRATION
Int er nat ional Hous e L ondon, 16 S t ukeley S t r eet , Covent Gar den, London WC2B 5LQ
Once completed send this form to CambridgeExams@ihlondon.com with a copy of your passport/EU ID Card
Examination required (please tick only one, use a separate form for each exam):
Cambridge English: First (FCE) £125
Cambridge English: Advanced (CAE) £130
Cambridge English: Proficiency (CPE) £135
Date of Exam:
First name (s):
Family name(s):
These names must be the same as the names on your passport/National Identity Card and must appear in the same
order.
Date of Birth: (DD/MM/YY)
/
/
Gender: Male
Female
Address in London:
Telephone Number:
Email Address:
Permanent Address (where certificate will be sent 2 months after the exam):
Passport or National ID number:
(this must be the ID you will bring
with you on the exam day)
Country of birth:
Nationality:
Name of institution where you are doing a Cambridge English exam preparation course (leave blank if you are not
doing a course)
Why are you taking the exam?
For studying abroad
For Visa purposes
For work
in which country
for which country
Other
Do you have any special requirements? For example, modified materials for visual difficulties, or special
requirements because of a medical condition.
Yes
No
– Please specify
Confirmation of your registration and details of the timetable for the examination days will be sent to you at least
two weeks before the examination date. The speaking exam will take place on a separate date. All exams are
paper-based.
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Please note that the examination fees are non-refundable and non-transferable.
Are you 18, or over 18, years of age?
Yes
No - please complete the box below
Declaration:
I understand that all individuals who want to take Cambridge English exam are required to agree to all of the Terms
and Conditions (a copy of which has been provided by the centre).
I wish to be admitted for the selected Cambridge exam at the centre listed on this form and for the date listed here. I
will bring a valid photo ID with me on the exam day(s), and I consent to have my photo taken by the centre on the
day of the Speaking exam and/or the written papers. I agree for this photo to be held on the secure Cambridge
English Language Assessment Results Verification site and viewed as set out below if I give my agreement.
Additionally, if I use my exam result for a Visa/immigration application I agree for the exam result to be available on
other sites shown at: http://www.cambridgeenglish.org/cambridge-english-for/visas-and-immigration/ if I give my
consent.
I hereby authorise the following to access my information (tick if appropriate):
UKBA
The photo shall only be available to organisations/individuals that I give my details to or that I authorise to view my
result.
By signing this form I declare that I am aware of and agree to comply with the Terms and Conditions for this exam.
Candidate Signature:
Are you 17, or under 17, years of age?
Date:
Yes – then you must get your parent/legal guardian to
complete this section:
Declaration:
I am the parent/legal guardian of the candidate named on this form and I give consent to this person taking the
Cambridge English exam selected above.
I understand that all individuals who want to take Cambridge English exam are required to agree to all of the Terms
and Conditions (a copy of which has been provided by the centre).
I agree to the candidate being admitted for the selected Cambridge English exam at the centre listed on this form
and for the date listed here. The candidate will bring a valid photo ID with them on the test day(s) and, I consent to
them having their photo taken by the centre on the day of the Speaking test and/or the written papers. I agree for
this photo to be held on the secure Cambridge English Language Assessment Results Verification site and viewed as
set out below if I give my agreement on behalf of the candidate.
Additionally, if the candidate is to use their exam result for a Visa/immigration application I agree for the exam result
to be available on other sites shown at: http://www.cambridgeenglish.org/cambridge-english-for/visas-andimmigration/ if I give my consent on behalf of the candidate.
I hereby authorise the following to access my information (tick if appropriate):
UKBA
The photo shall only be available to organisations/individuals that I agree to the giving the candidate’s details to or
authorise to view the candidate’s result.
By signing this form I declare that I am aware of and agree to comply with the Terms and Conditions for this exam.
Parent/Guardian Signature:
Date:
Candidate Signature:
Date:
For Reception use only: Amount Paid:
Method of Payment:
Date:
Receipt No.:
Signed (for Reception):
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Cambridge Credit/Debit Card Payment form
Card Number:
Valid From:
M M
Issue Number: (if present)
Card Security Code:
/
Y
Y
Expiry Date:
M
Amount:
£
M
/
Y
Y
This is the last three digits of the number on the reverse of the card, on
the signature strip.
Name as it appears the card:
Cardholder address:
Cardholder’s signature:
Date:
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