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
 International Legal English Certificate (ILEC)
 International Certificate in Financial English (ICFE)
Examination Date (written papers):
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:
We will send the Confirmation of Entry to your email address at least 10 days before the examination.
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
£50.00
£60.00
£95.00
£100.00
£105.00
KET
PET
FCE
CAE
CPE
£70.00
£90.00
£110.00
£130.00
£110.00
BEC Preliminary
BEC Vantage
BEC Higher
ILEC
ICFE
The late entry fee of £25.00 applies from 17:00 on the closing entry date.
Exam Dates
You can download the 2013 exams flyer from our website www.birmingham.gov.uk/brasshouse
Brasshouse Language Centre will run all sessions, numbers permitting.
availability.
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.