Cambridge English: General English Examinations Block Registration Form

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Cambridge English: General English Examinations Block Registration Form I wish to register candidates for the following examination: Please tick Examination Exam date Speaking Test Window Final Registration Exam fee KET (PB) Sa 15 Mrz 14 Sa 15 Mrz 14 07.02.2014 130 KET (PB) Do 05 Jun 14 Do 05 Jun 14 02.05.2014 130 KET (CB) Do 20 Nov 14 Do 20 Nov 14 06.11.2014 155 PET (PB) Sa 15 Mrz 14 Sa 15 Mrz 14 07.02.2014 140 PET (PB) Do 05 Jun 14 Do 05 Jun 14 02.05.2014 140 PET (CB) Do 20 Nov 14 Do 20 Nov 14 06.11.2014 165 FCE (PB) Fr 14 Mrz 14 Fri 7 Mar to Thu 13 Mar 07.02.2014 200 FCE (PB) Do 26 Jun 14 Fri 13 Jun to Fri 27 Jun 09.05.2014 200 FCE (PB) Do 21 Aug 14 Mon 18 Aug to Fri 22 Aug 18.07.2014 200 FCE (PB) Di 02 Dez 14 Fri 14 Nov to Fri 5 Dec 17.10.2014 200 FCE For Schools (PB) Mi 04 Jun 14 Fri 30 May to Fri 6 Jun 25.04.2014 200 FCE For Schools (PB) Di 25 Nov 14 Fri 14 Nov to Tue 25 Nov 17.10.2014 200 CAE (PB) Mi 05 Mrz 14 Fri 28 Feb to Fri 7 Mar 31.01.2014 205 CAE (PB) Mi 11 Jun 14 Fri 23 May to Fri 13 Jun 17.04.2014 205 CAE (PB) Fr 22 Aug 14 Mon 18 Aug to Thu 21 Aug 18.07.2014 205 CAE (PB) Mi 03 Dez 14 Fri 14 Nov to Fri 5 Dec 17.10.2014 205 CPE (CB) Sa 22 Mrz 14 Mon 17 Mar to Sat 22 Mar 07.03.2014 235 CPE (PB) Do 12 Jun 14 Fri 23 May to Fri 13 Jun 17.04.2014 210 CPE (PB) Do 04 Dez 14 Fri 14 Nov to Fri 5 Dec 17.10.2014 210 *PB = Paper-Based **CB = Computer-Based Please note there are limited places available for computer-based examinations. Places are allocated on a first come, first served basis. Institution/Company details: Company name: Contact person: Email address*: Contact number: Billing Address: *The payment receipt and Confirmation of Entry, including candidates exam timetables will be sent to this email address. Mobile phone number: City/town: Post code: Country: If you wish the certificates to be sent to an address other than the above, please specify here: - 1 - Office use: CI Sys Informed

Do any of your candidates have any special requirements? For example, modified materials for visual/hearing difficulties. The completed examination entry form and examination fees must reach the Cambridge Exam Centre s office in Munich by the Final Registration ; otherwise your entries cannot be accepted. The correct fees should be paid at the Cambridge Exam Centre s office in Munich (, ) or transferred to: Stadtsparkasse München, Konto-Nr. 39 77 94 BLZ 701 500 00 BIC SSKMDEMM IBAN DE85 7015 0000 0000 3977 94 Please include evidence of payment with this registration form. Registrations will only be processed once the examination fees have been paid for in full. Before completing this form, please read the Candidate Information Sheet (Block Entries) supplied with this form (see page 3 and 4). Declaration: I understand that, if a candidate is prevented from taking the examination, the exam fee will not be returned or carried forward to a later examination (see page 3). By signing this form I declare that I am aware of and agree to comply with the Terms and Conditions (page 1, 2, 3 and 4) for this examination. I wish to register the candidates (listed on block entry form) for the selected examination and agree to comply with Cambridge ESOL s regulations for the examination and with the arrangements made by the Munich Examination Centre. Candidates are aware that the examination centre is obliged to take a test-day photo of each candidate on the day of their Speaking test. Name Signature - 2 -

1. Examination Details Candidate Information Sheet Exam* Exam date Speaking Test *PB = Paper-Based CB = Computer-Based **Estimated dates; please refer to your Confirmation of Entry for confirmation of the date your result will be published online. 2. Confirmation of Entry A Confirmation of Entry giving dates, times and Munich location of your Written, Listening & Speaking tests will be sent to you by email not later than 15 (paper based examinations) / 5 (computer based examinations) working days before the written exam date. If you have NOT received your Confirmation of Entry by this deadline, please contact us immediately at exams@cambridgeinstitut.de 3. Withdrawal from an Examination If you have registered, but are prevented from taking an examination, your fee will not be returned or carried forward to a later examination. Cambridge University will consider applications for refunds on medical grounds if a doctor s certificate is produced stating that the candidate was unable to take the examination through ill-health. Applications for refunds should be made by letter to this centre and will be forwarded to Cambridge ESOL. A doctor s certificate must be enclosed. The refund amounts to 50% of the total exam fee. The letter enclosing your medical certificate should contain details of your bank and account number and must reach this centre not later than 5 working days after the Written exam. 4. Answer Scripts Answer scripts become the property of the University of Cambridge and are not returned to candidates or this examination centre. 5. Test-Day Photo You should be aware that the examination centre is obliged to take a test-day photo of each candidate on the day of their speaking test. 6. Identification / Passport Candidates are required to provide photographic identification for each paper on the day of the examination. Failure to present a Passport/I.D. may result in not being allowed to take the exam. - 3 - Final Registration Exam fee Results release date** Certificates despatched KET (PB) Sa 15 Mrz 14 Sa 15 Mrz 14 07.02.2014 130 29.04.14 30.05.2014 KET (PB) Do 05 Jun 14 Do 05 Jun 14 02.05.2014 130 17.07.14 20.08.2014 KET (CB) Do 20 Nov 14 Do 20 Nov 14 06.11.2014 155 04.12.14 09.01.2015 PET (PB) Sa 15 Mrz 14 Sa 15 Mrz 14 07.02.2014 140 29.04.14 30.05.2014 PET (PB) Do 05 Jun 14 Do 05 Jun 14 02.05.2014 140 17.07.14 20.08.2014 PET (CB) Do 20 Nov 14 Do 20 Nov 14 06.11.2014 165 04.12.14 09.01.2015 FCE (PB) Fr 14 Mrz 14 Fri 7 Mar to Thu 13 Mar 07.02.2014 200 29.04.14 30.05.2014 FCE (PB) Do 26 Jun 14 Fri 13 Jun to Fri 27 Jun 09.05.2014 200 07.08.14 05.09.2014 FCE (PB) Do 21 Aug 14 Mon 18 Aug to Fri 22 Aug 18.07.2014 200 03.10.14 31.10.2014 FCE (PB) Di 02 Dez 14 Fri 14 Nov to Fri 5 Dec 17.10.2014 200 21.01.15 20.02.2015 FCE For Mi 04 Jun 14 Fri 30 May to Fri 6 Jun 25.04.2014 200 16.07.14 20.08.2014 Schools (PB) Di 25 Nov 14 Fri 14 Nov to Tue 25 Nov 17.10.2014 200 14.01.15 13.02.2015 CAE (PB) Mi 05 Mrz 14 Fri 28 Feb to Fri 7 Mar 31.01.2014 205 16.04.14 16.05.2014 CAE (PB) Mi 11 Jun 14 Fri 23 May to Fri 13 Jun 17.04.2014 205 23.07.14 20.08.2014 CAE (PB) Fr 22 Aug 14 Mon 18 Aug to Thu 21 Aug 18.07.2014 205 06.10.14 31.10.2014 CAE (PB) Mi 03 Dez 14 Fri 14 Nov to Fri 5 Dec 17.10.2014 205 22.01.15 20.02.2015 CPE (CB) Sa 22 Mrz 14 Mon 17 Mar to Sat 22 Mar 07.03.2014 235 04.04.14 02.05.2014 CPE (PB) Do 12 Jun 14 Fri 23 May to Fri 13 Jun 17.04.2014 210 24.07.14 20.08.2014 CPE (PB) Do 04 Dez 14 Fri 14 Nov to Fri 5 Dec 17.10.2014 210 23.01.15 20.02.2015

Information Sheet (Block Entries) For the Cambridge Examinations in English This form lists the responsibilities of the person entering a number of candidates for a Cambridge examination. Please ensure you 1. enter the names of candidates on the form giving the candidate s full name, date of birth, email address and his/her telephone number at work or home. ALL ENTRY DETAILS SHOULD BE IN BLOCK LETTERS. 2. give each candidate a copy of the Candidate Information Sheet supplied with this form. This is important as it lists important information concerning the examinations, including further details about the speaking tests and the reimbursement of fees when, through illness, a candidate is prevented from taking the examination. Candidates should also be advised that answer scripts become the property of the University of Cambridge and are not returned to examination candidates or to this Regional Centre. Further, Candidates are required to provide photographic identification for each paper on the day of the examination. Failure to present a Passport/I.D. may result in not being allowed to take the exam. 3. collect the stipulated fees from each candidate. Candidates are asked not to settle fees with us individually. Please transfer the total amount of your block entry to the following bank account: Cambridge Examinations, Stadtsparkasse München Account no. 397794 Bank code 701 500 00 BIC SSKMDEMM IBAN DE85 7015 0000 0000 3977 94 Please note: (i) Registrations will only be processed if the examination fees have been paid for in full. Please provide proof of payment when registering candidates. (ii) If your company/institution requires invoicing for the total fees, please inform us of this well in advance of the final registration date. Both the block entry form and the examination fees must reach us not later than the final registration date. As soon as the registrations have been processed you will receive a receipt. If you require an invoice in advance please contact us at exams@cambridgeinstitut.de 4. pass on to candidates the individual Confirmation of Entries, giving the dates, times and venue of the Written, Listening and Speaking tests. These will be sent to you not later than 15 (paper based examinations) / 5 (computer based examinations) working days before the Written tests. If you have NOT received the candidates Confirmation of Entry by this deadline, please contact us at exams@cambridgeinstitut.de - 4 -

December 2013-5 -