Cambridge ESOL YLE _Movers_ Registration Form 2012

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Cambridge ESOL YLE (Movers) Registration Form. ➀ ... This is the only form of identity that will be accepted on the test day. ... Speaking Test date: _ _ /_ _ / 2012.
Cambridge ESOL YLE (Movers) Registration Form

Test date: _ _ / _ _ /20_ _ Please attach a recent passport-sized photograph here securely (Note: the photograph must not be more than six months old)

Family name: ______________________________ First name: ________________________________ Address: __________________________________ __________________________________ __________________________________ __________________________________ Telephone / Mobile number: ____________________________________ E-mail: ______________________________________________________ Date of birth: _ _ /_ _ / _ _ _ _

(dd/mm/yyyy)

Please indicate which document the child will be using as proof of identity and give the number below. N.B: Candidates taking the test outside their own country must present a current passport. You must bring the ID indicated below to the test. This is the only form of identity that will be accepted on the test day. The document must be valid/not expired at registration and on the test day. (Tick one of the two boxes)

Passport

National ID Card

Passport or National ID Card number: For office use only Date of payment: _ _ / _ _ /2012 (dd/mm/yyyy)

ID checked

Receipt number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Speaking Test date: _ _ /_ _ / 2012

Administrator’s initials:

Page | 1

Time: _ _ _ _ _

Candidate number: _ _ _ _ _ _ _ _ _

Country or region of origin: ________________________

First language: __________________________________

Why is the child taking the test? (Please circle) A B C

For studies Immigration purposes Other (Please specify _______________________________________________________ )

Has he/she ever taken one of the Cambridge ESOL exams before? (Tick one of the two boxes below) Yes

No

N.B: If your answer is “Yes”: Which of the following Cambridge ESOL Exams has he/she taken? (Please tick) YLE (Starters)

YLE (Movers)

YLE (Flyers)

When did he/she take this exam? _ _ / _ _ / _ _ _ _ (dd/mm/yyyy) Where did he/she take this exam? __________________________________________________

Has he/she attended a YLE (Movers) Preparation Course?

Yes

N.B: If your Answer is “Yes”, where was it? (Please tick) at Language Solutions Algeria in other School

(Please specify _________________________________________)

How many years has he/she been studying English? (Please tick) 1 (less than)

Page | 2

2

3

4

5

6

7

8

9 (or more)

No

Does the child have any special requirements due to ill health/medical conditions? (Please tick)

Yes

No

If your answer is “Yes”, please specify the requirements below. You must attach supporting medical evidence to this form. Requests for modified materials must be submitted at least three (03) months before the test. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________

Parents’ signature

Date

Page | 3

_ _ / _ _ / 20_ _