Cambridge English Language Assessment (CELA)
Individual Candidate Registration Form (EXTERNAL)
Please tick () the appropriate box to indicate the examination.
 Key English Test (KET)
 Preliminary English Test (PET)
 First Certificate in English (FCE)
 Certificate in Advanced English (CAE)
 Certificate in Proficiency of English (CPE)
 Preliminary Business English Certificate
 Vantage Business English Certificate
 Higher Business English Certificate
Examination Date (written papers):
Please attach a copy of your passport.
Are you taking an exam for visa purposes e.g. Spouse visa or other visa categories requiring
Secure English Language Tests (for example Tier 4 for study purposes)?  Yes  No
If yes, on the day of the exam you MUST bring your passport as proof of identification. You
will have a test day photograph taken and a sample of your voice will be recorded.
PERSONAL DETAILS
Candidate First Name(s):
Candidate Family Name(s):
Date of Birth (dd / mm / yyyy):
Male / Female:
Candidate’s Address (UK):
Telephone Number:
Email Address:
If you would like to choose your partner for the speaking examination, please write their name
here. This person MUST also be entered for this examination. If not, Brasshouse will allocate
you a partner.
Candidates First Name(s):
Candidates Family Name(s):
PAYMENT DETAILS
 Cash
 Credit / Debit Card
 Postal Order (Birmingham City Council)
 Visa
 Mastercard
 Debit Card
Other
Cardholder’s Name:
Card Number (16 digits):
Issue Number:
Expiry Date:
Please write the last 3 digits of your security code number:
I wish to be admitted to this examination. I am aware of and agree to comply with the regulations for this examination and with the arrangements made by the Centre
Exams Manager. I have informed the Centre Exams Manager if I have special needs of any kind (see overleaf). I understand that my examination results may be made
available online to accredited institutions such as universities, professional bodies and government departments to enable them to authenticate the results.
Signature of Candidate:
Date:
Brasshouse Language Centre
50 Sheepcote Street
Birmingham
B16 8AJ
Jo Johnson, Centre Exams Manager (CEM)
Telephone: 0121 303 1637
Facsimile: 0121 464 5375
E-mail: Jo_O_Johnson@birmingham.gov.uk
SPECIAL CIRCUMSTANCES
Please describe any special circumstances (e.g. a medical condition) that could affect your ability to
do the exam. For medical conditions you MUST provide a medical certificate at least 2 weeks
before the entry closing date.
Price List
£70.00
£80.00
£110.00
£120.00
KET
PET
FCE
CAE
£130.00
£110.00
£120.00
£130.00
CPE
BEC Preliminary
BEC Vantage
BEC Higher
The late entry fee of £25.00 applies from 17:00 on the closing entry date.
Exam Dates
You
can
download
the
2014
exams
flyer
from
http://brasshouse.birmingham.gov.uk/brasshouse-english/cambridge-examinations/
Brasshouse Language Centre will run all sessions, numbers permitting.
availability.
our
website
Please contact us for
All closing entry dates are provisional and subject to amendment.
Brasshouse Language Centre will schedule your speaking exam on any of the dates mentioned on the
calendars. We therefore recommend keeping all dates within the speaking test period available as we
will inform you about the exact date approximately 10 days in advance.
Terms & Conditions
After the closing entry date, the local fee is non-refundable. If a candidate misses the examination due
to illness or withdraws his or her entry on medical grounds, CELA will consider making a full refund of
the university fee. The candidate must provide Brasshouse Language Centre with a letter from a
medical practitioner, explaining the medical reasons why the candidate was unable to sit the
examination. Entry fees are non-refundable where no acceptable proof of medical or other grounds
can be provided.
If you change your address, you must let us know immediately.
This form should be returned to Brasshouse Language Centre. This is not an entry form and should
not be returned directly to CELA.