Ielts Application Form
Ielts Application Form
Ielts Application Form
Application form
Please return to:
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second choice
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These names must be the same as the names on your passport/National Identity Card
and must appear in the same order.
Academic
General Training
Please note that it is the candidates responsibility to select the test module that best meets their needs.
The General Training module is not available on every test date.
7 Address: Please note you will only be sent one copy of your results.
Zip/Postal code
8 Telephone
Mobile number
9 Email
Please provide full and accurate contact information including postal address, phone and mobile number and email which are in constant and valid use.
The test centre or the test partner may contact candidates before or after the test to access the full test registration and administration.
10 Date of birth
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11 Gender
(circle as appropriate)
12 Please indicate which document you will be using as proof of identity and give the number below.
Candidates taking the test outside their own country must use a current passport.
You must bring the ID document 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.
Passport
test date
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ID checked
AC
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receipt number
Administrators initials
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For questions 1316 please enter codes and the name of the country of nationality and first language.
You can find codes on pages iiiv. Please take care and enter this information accurately.
If the codes you enter here are incorrect, the information on your Test Report Form will also be incorrect.
13 Country of nationality (code)
11
12
15 Occupation (sector)
13
Occupation (level)
Canada
New Zealand
Republic of Ireland
United Kingdom
degree or equivalent
postgraduate
9 (or more)
23
21 Do you have a permanent disability, such as a visual, hearing or specific learning difficulty, which requires special
arrangements (for example, modified material, extra time, use of technology, etc.)?
yes
no
If yes, please specify your requirements below. You must attach original supporting medical evidence to this form.
The medical evidence must be in the form of a report prepared in a period no more than two years before the test
date. You must submit requests for modified test materials at least three months before the test.
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Notice to Candidates
IELTS test terms and conditions
You must
provide proof of your identity (passport or National Identity Card) at
registration. Contact the test centre to confirm which type of identity
document is accepted. Candidates taking the test outside their own country
must use a passport.
inform the centre of any changes to your identity document before the test
date. If you do not do this you will not be allowed to take the test and you will
not be eligible for a refund or transfer.
bring the same identity document on the test day as the one recorded in
your application. If you do not do this you will not be allowed to take the test
and you will not be eligible for a refund or transfer.
arrive at the centre before the scheduled test start time. If you arrive late, you
will not be allowed to take the test and you will not be eligible for a refund or
transfer.
leave all personal belongings in the designated belongings area. The only
items you may bring into the test room are your approved identity document,
standard pen(s), pencil(s) and eraser(s), and a bottle of water (label-free). All
electronic devices, including watches, must be left in the belongings area and
must be switched off. Centres may use metal detectors to scan for electronic
devices. Any candidate who breaches these conditions will not receive an
IELTS test result or be eligible for a refund or transfer. While the centre will
take all reasonable measures to secure your items in the belongings area,
they cannot be held responsible for any loss.
consent for your identity to be verified both at test registration and on test
day. This may include:
having your photograph taken. You will be required to temporarily remove
any covering from your face. Any candidate who refuses to have a
photograph taken will not be allowed to sit the test and will not be entitled
to a refund. The photograph taken by the centre will appear on your Test
Report Form.
providing a sample of your signature.
having your finger scan taken.
keep only the following items on your desk: your identity document, pen(s),
pencil(s), eraser(s), and a bottle of water (label-free).
tell the invigilator at once if you think you have not been given the correct
question paper or if the question paper is incomplete or illegible.
raise your hand if you need to ask the invigilator something. Candidates may
not ask for, and will not be given, any explanation of the test questions.
attend all four components of the test. If you do not attend all four components,
you will not receive an IELTS test result. Exceptions are possible but must
be requested at registration and written approval must be received from
the centre.
inform the invigilator on the day of the test if you believe that your
performance may be affected by ill health, by the way in which the test
is delivered at the centre or for any other reason. If you have a complaint
relating to the delivery of the test, you must submit your complaint to the test
centre before you leave the centre on test day. Complaints relating to the
delivery of the test will not be accepted after test day.
leave all test materials in the test room at the end of the test. The test materials
include question papers, Speaking booklets, answer sheets and rough
paper. Any candidate who attempts to remove test materials from the test
room will not receive an IELTS test result.
*Important: Please detach this section (pages iiv) and retain for your own records.
i
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001
237
002
003
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005
006
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239
007
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029
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036
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244
043
044
045
219
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047
096
048
049
245
050
051
052
053
054
055
056
057
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and
McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic Peoples
Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao Peoples Democratic
Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
058
059
060
061
062
224
063
064
065
066
067
068
246
069
070
071
072
073
074
075
076
077
078
079
080
081
082
083
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000
Afrikaans
Akan
Albanian
Amharic
Arabic
Armenian
Assamese
Aymara
Azeri
Baluchi
Bambara
Basque
Bemba
Bengali
Bihari
Bosnian
Breton
Bulgarian
Burmese
Byelorussian
Catalan
Chinese
Creole
Croatian
Czech
Danish
Dari
Dutch
Dzongkha
Efik
English
Estonian
Ewe
Faeroese
Farsi
Fijian
Filipino
Finnish
Flemish
French
Fulani
Ga
Galician
Georgian
German
Gilbertese
Greek
Gujarati
Haitian Creole
Hausa
Hebrew
Hindi
Hungarian
Ibo/lgbo
Icelandic
Igala
Indonesian
Irish
Italian
Japanese
Javanese
Kannada
Kashmiri
Kazakh
Khmer
Korean
Kurdish
Lao
Latvian
Lithuanian
Luba
Luo
Luxemburgish
Macedonian
Malagasy
Malay
Malayalam
Malinka
001
002
003
004
005
006
007
008
009
010
011
012
013
014
015
901
016
017
018
019
020
021
022
023
024
025
026
028
027
029
030
031
032
033
034
035
904
036
037
038
039
040
903
041
042
043
044
045
046
047
048
049
050
051
052
053
054
137
055
056
057
058
059
060
061
062
063
064
065
066
067
068
069
902
070
071
072
073
Maltese
Maori
Marathi
Marshallese
Masai
Mende
Mongolian
Nepali
Norwegian
Oriya
Palauan
Pashto
Polish
Ponapean
Portuguese
Punjabi
Pushtu
Quechua
Rajasthani
Riff
Romanian
Romansch
Russian
Samoan
Scottish Gaelic
Serbian
Setswana
Shona
Sindhi
Singhalese
Slovak
Slovene
Somali
Spanish
Swahili
Swazi
Swedish
Tagalog
Tahitian
Tamil
Tatar
Telugu
Tetum
Thai
Tibetan
Tigrinya
Tongan
Trukese
Tulu
Tupi/Guarani
Turkish
Uighur
Ukrainian
Ulithian
Urdu
Uzbek
Vietnamese
Welsh
Wolof
Xhosa
Yao
Yapese
Yiddish
Yoruba
Zulu
Other
074
075
076
077
078
079
080
081
082
083
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000
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Question 15 Occupation
Example
If you are a student, enter 08 because the sector
is Education and 7 because the level is Student.
0
Sector
Administrative Services
Agriculture, Fishing, Forestry, Mining
Arts and Entertainment
Banking and Finance
Catering and Leisure
Construction Industries
Craft and Design
Education
Health and Social Services
Installation, Maintenance and Repair Services
Law and Legal Services
Manufacturing and Assembly Industries
Personal Services
Retail Trade
Technical and Scientific
Telecommunications and the Media
Transport
Utilities (gas, water etc.)
Wholesale Trade
Other
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
00
Level
Self-employed
Employer/Partner
Employee (Senior level)
Employee (Middle or Junior level)
Worker in the home
Retired
Student
Other
1
2
3
4
5
6
7
0
Checklist
I have signed the Application Form.
I have provided all the information required.
I have paid the test fee.
(Please note that your application will not be
processed without this.)
I have attached a photocopy of my passport /
National Identity Card (pages showing
personal identification details and expiry date).
iv
1
2
3
4
5
6
7
8
9
10
0
* Important: Please detach this section (pages iiv) and retain for your own records.
06/10/2014 10:06
Name of person/department
Name of institution/agency/body/employer
File/case number
Address
b) Name of person/department
Name of institution/agency/body/employer
File/case number
Address
c)
Name of person/department
Name of institution/agency/body/employer
File/case number
Address
d) Name of person/department
Name of institution/agency/body/employer
File/case number
Address
e)
Name of person/department
Name of institution/agency/body/employer
File/case number
Address
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Declaration
1.
I acknowledge that the IELTS test is jointly owned by British Council, IELTS Australia Pty Ltd (ABN 84 008 664 766), which is wholly owned by IDP
Education Ltd (IDP:IELTS Australia) and Cambridge English Language Assessment (part of the University of Cambridge), collectively referred to as
the IELTS Test Partners.
2.
3.
I understand that the personal data in my application is collected for the purposes of the IELTS test, and I consent for this data to be disclosed to,
processed and stored by the IELTS Test Partners for the purpose of such administration. I further consent for this data, including, without limitation,
test performance or score data and my test result to be disclosed by the IELTS Test Partners to those Recognising Organisations to which I apply and
to governments (including visa processing authorities) for the purpose of allowing these organisations to verify my test result or to carry out enquiries
in relation to suspected malpractice. If the IELTS Test Partners discover that a false or altered Test Report Form has been provided to any of these
Recognising Organisations or government authorities I further consent that the IELTS Test Partners may inform the same and provide them with my
personal data and any relevant details relating to the work I produce as part of my test taking, including, without limitation, test performance or score data.
4.
I understand that my personal data may be processed in an anonymous form by the IELTS Test Partners for statistical and research purposes. The
IELTS Test Partners and the centre administering the test confirm that they will not disclose personal information about candidates to others except as
stated in this Declaration or to the extent permitted by law.
5.
I understand that I may view a copy of my personal data contained in the Application Form by contacting ielts@cambridgeenglish.org. I understand
that a fee will be charged for access to this information.
6.
I understand that if I want a copy of my finger scan it can only be provided as a Binary Large Object (BLOB) and the request must be made to
ielts@idp.com or ielts@britishcouncil.org. I understand a fee will be charged for access to this information.
7.
I understand that if the details on this form are not completed my application may not be processed. I further understand that completing and
submitting this Application Form does not guarantee registration on my preferred test date or at my preferred test location. I understand that my
registration will be confirmed in writing from the centre.
8.
I understand that any personal data collected during the identity verification process by the centre either at test registration or on test day will be
processed and securely stored by the IELTS Test Partners for the purpose of the IELTS test. I acknowledge that the photograph taken of me by the
centre will be provided to any Recognising Organisations or government authorities (including visa processing authorities) to which I apply for the
purposes of allowing these organisations to verify my test results or to carry out enquiries in relation to possible malpractice or test integrity issues.
I understand that where finger-scan data is obtained it will not be disclosed to any entity except the IELTS Test Partners.
9.
I understand that I will have my photograph taken by the centre to allow the Test Report Form to be released. If I have not had my photograph taken
by the centre no result will be issued.
10.
I acknowledge that I have read the IELTS Notice to Candidates on page i and agree to abide by the rules and regulations contained therein.
11.
I understand there may be local terms and conditions I must comply with and that the centre will provide details of these on request.
12.
I understand that I must attend all four test components in order to receive an IELTS test result and that any exception to this must be approved in
advance by the centre.
13.
I understand that the IELTS Test Partners have a responsibility to all candidates and Recognising Organisations to ensure the highest confidence
in the accuracy and integrity of test results and that the IELTS Test Partners therefore reserve the right to withhold test results temporarily or
permanently, or to cancel test results which have been issued, if they consider those results to be unreliable for reasons of suspected malpractice
or any other irregularity in the test process.
14.
I understand that my result may not be issued 13 days after the test if any of the IELTS Test Partners deem it necessary to review any matter associated
with my test or the administration of my test, including making enquiries as to whether any rules or regulations have been breached. I understand that I
may be required to provide additional samples of my writing and speaking for the purposes of assisting any investigation before or after the test.
I understand that in exceptional circumstances I may be required to re-take one or more IELTS components.
15.
I understand that if I am suspected of engaging in any form of malpractice, or do anything that might damage the integrity and security of IELTS, I
may not receive a test result, my test fee will not be refunded and I may be prohibited from taking the IELTS test in the future. Despite and without
limiting any of the terms of this Declaration, I understand that details of any malpractice (including evidence of suspected malpractice) that has been
established, is suspected, or is being formally investigated may be provided to Recognising Organisations, including visa processing authorities and
appropriate regulatory authorities, or otherwise disclosed in accordance with the law, where required for verification purposes or other purposes to
protect the IELTS test and its stakeholders against any form of malpractice. I further understand that suspected malpractice will be reported centrally
to the IELTS Test Partners and to any relevant test centre by the centre where the suspected malpractice occurred.
16.
I understand that if any other person attempts to take the IELTS test in my place, both I and such person will be liable to prosecution. Details relating to
the situation will be provided to the relevant authorities, including visa processing authorities and appropriate regulatory authorities.
17.
I understand that the work I produce in the IELTS test remains the property of the IELTS Test Partners. It will not be released to candidates or to
institutions or organisations, except in the investigation of suspected malpractice whereby my work may be provided to relevant authorities.
18.
I understand that my Speaking test will be recorded. I understand that in the event the test does not record I will be required to re-take the Speaking
test. I also agree that an observer may attend my Speaking test as part of the monitoring process.
19.
I understand that I will be charged the full test fee if I cancel my test or request a transfer within five weeks of the test date, unless I provide
appropriate medical evidence, within five days of the test date, to support the cancellation or transfer.
20.
I acknowledge that I have read the IELTS Information for Candidates booklet.
Disclaimer: The International English Language Testing System (IELTS) is designed to be one of many factors used by academic institutions, government
agencies, professional bodies and employers in determining whether a test taker can be admitted as a student or be considered for employment or for
citizenship purposes. IELTS is not designed to be the sole method of determining admission or employment for the test taker. IELTS is made available
worldwide to all persons, regardless of age, gender, race, nationality or religion, but it is not recommended to persons under 16 years of age.
Signature
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Date
d m m y
*8284598837*
British Council, IDP: IELTS Australia and Cambridge English Language Assessment and any other party involved in creating, producing, or delivering
IELTS shall not be liable for any direct, incidental, consequential, indirect, special, punitive, or similar damages arising out of access to, use of,
acceptance by, or interpretation of the results by any third party, or any errors or omissions in the content thereof.
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