NOT FOR SALE

Application form

Please return to:

PLEASE WRITE IN BLOCK CAPITALS

1 Preferred date of test d d m m y y second choice d d m m y y

2 Test city location
3 Last name (family name/surname)
4 Title (Dr/Mr/Mrs/Miss/Ms)
5 First (given) name(s)
These names must be the same as the names on your passport/National Identity Card
and must appear in the same order.
6 Which IELTS test module are you taking? (tick one box only) Academic
General Training
Please note that it is the candidate’s 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 IELTS Test Partner may contact candidates before or after the test to access the full test registration and administration.

10 Date of birth d d m m y y 11 Gender   F  M   (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 National Identity Card

Passport or National Identity Card number

For office use only

scheme test date d d m m y y
date of payment
d d m m y y receipt number

ID checked Administrator’s initials­

AC  GT Please turn over 1

 For questions 13–16 please enter codes and the name of the country of nationality and first language.
You can find codes on pages ii–iv. 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

Country of nationality (name)

14 First language (code)

First language (name)

15 Occupation (sector)
13 if other, please specify

Occupation (level) if other, please specify

16 Why are you taking the test?
if other, please specify

17 Which country are you applying to/intending to go to?

15 (tick one box only)

Australia        Canada        New Zealand        Republic of Ireland        United Kingdom

United States of America        other, please specify

18 Where are you currently studying English (if applicable)?

19 What level of education have you completed?
21 (tick one box only)

    secondary up to 16 years      secondary 16–19 years       degree or equivalent       postgraduate

20 How many years have you been studying English?

22 (tick one box only)

1 (or less than)      2      3      4      5      6      7      8      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.

2
 Notice to Candidates
IELTS test terms and conditions Candidates engaging in malpractice will not be allowed to complete the test
and will not receive an IELTS test result. Candidates engaging in malpractice
may be banned from taking the test in future, and may be liable to legal
You must … action. Candidates engaging in malpractice may be reported to regulatory
• provide proof of your identity (passport or National Identity Card) at authorities globally.
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. Your IELTS test result
• 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 • Results are issued by centres, usually 13 days after the test.
not be eligible for a refund or transfer. • You will receive only one copy of your Test Report Form. Replacement
• bring the same identity document on the test day as the one recorded in copies are not issued in the event of loss or damage.
your application. If you do not do this you will not be allowed to take the test • The Test Report Form will be issued in your name as it appears on the identity
and you will not be eligible for a refund or transfer. document used at registration. If you find that your personal details are
• arrive at the centre before the scheduled test start time. If you arrive late, you incorrect on the Test Report Form, please contact the centre where you took
will not be allowed to take the test and you will not be eligible for a refund or the test. Documentation must be provided to verify the correct details. If you
transfer. change your name after receiving your Test Report Form, the name will not be
• leave all personal belongings in the designated belongings area. The only changed on the Test Report Form.
items you may bring into the test room are your approved identity document, • Your result may not be issued 13 days after the test if the IELTS Test
standard pen(s), pencil(s) and eraser(s), and a bottle of water (label-free). Partners decide that it is necessary to review any matter associated with
All electronic devices and all watches must be left in the belongings area your test or the administration of your test. To assist any investigation, you
and must be switched off. You may be electronically scanned for devices at may be required to provide writing and speaking samples. In exceptional
any time during the test day. Any candidate who breaches these conditions circumstances you may be required to re-take one or more IELTS
will not receive an IELTS test result or be eligible for a refund or transfer. components.
While the centre will take all reasonable measures to secure your items in the • Your result may be cancelled after it has been issued if any irregularity is
belongings area, they cannot be held responsible for any loss. identified. You may be required to re-take one or more IELTS components.
• consent for your identity to be verified both at test registration and on test • Your result will be disclosed to the Recognising Organisations which you
day. This may include: nominated in your application or to which you applied with your Test Report
– having your photograph taken. You will be required to temporarily remove Form, for the purpose of allowing those organisations to verify the result or to
any covering from your face. Any candidate who refuses to have a carry out any enquiries in relation to suspected malpractice.
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 • If any of the data on the Test Report Form provided by you or your agent to
Report Form. Recognising Organisations has been altered in any way, your original test
– providing a sample of your signature. result may be cancelled.
– having your finger scan taken. • Candidates are not permitted access to the work they produce in the
• keep only the following items on your desk: your identity document, pen(s), IELTS test.
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 Cancelling your IELTS test o
­ r requesting a transfer
question paper or if the question paper is incomplete or illegible.
• raise your hand if you need to ask the invigilator something. Candidates may • For information on cancelling your IELTS test or requesting a transfer, please
not ask for, and will not be given, any explanation of the test questions. go to ielts.org.
• 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 How IELTS uses your information
the centre.
• inform the invigilator on the day of the test if you believe that your • The IELTS Test Partners recognise and support the right of IELTS test
performance may be affected by ill health, by the way in which the test candidates to privacy.
is delivered at the centre or for any other reason. If you have a complaint • When you provide your identity information the IELTS Test Partners link that
relating to the delivery of the test, you must submit your complaint to the test information to your IELTS test and test result on the Test Report Form. This
centre before you leave the centre on test day. Complaints relating to the enables you to submit your Test Report Form to Recognising Organisations
delivery of the test will not be accepted after test day. and for them to verify your result.
• leave all test materials in the test room at the end of the test. The test materials • Test Report Forms will only be sent to those Recognising Organisations
include question papers, Speaking booklets, answer sheets and rough nominated by the candidate in their application or at the request of the
paper. Any candidate who attempts to remove test materials from the test candidate after the issue of results. When a candidate submits a Test Report
room will not receive an IELTS test result. Form to a Recognising Organisation they consent to the verification of the
result by that organisation.

You must not … • The IELTS Test Partners or their authorised representatives may share
candidate personal data including without limitation test performance or
• talk to or disturb other candidates once the test has started. score data or photographs taken by the centre with educational institutions,
• lend anything to, or borrow anything from, another candidate during the test. governments (including visa processing authorities), professional bodies
• eat or smoke in the test room. and commercial organisations that recognise IELTS scores (‘Recognising
Organisations’) or law enforcement agencies and regulatory authorities
• leave the test room without the permission of the invigilator. where required for verification purposes or other purposes to protect the
• leave your seat until all test materials have been collected and you have IELTS test and its stakeholders against any form of malpractice. Finger-scan
been told you can leave. data, where obtained, will not be disclosed to any entity except the IELTS
• engage in any form of malpractice which may damage the integrity and Test Partners.
security of the IELTS test. Malpractice includes, but is not limited to: • The IELTS Test Partners will retain work produced by candidates in the
–a ttempting to cheat in any way, including using notes of any kind from IELTS test and may use it for quality control purposes and for investigations
any source. into suspected malpractice. Test score data and test responses, in an
– helping another candidate to cheat. anonymous form, may also be used for informational, research, statistical
– impersonating another candidate or having another candidate or training purposes.
impersonate you.
– copying the work of another candidate.
– disrupting the test in any way.
– reproducing any part of the test in any medium.
– attempting to alter the data on the Test Report Form.

*Important: Please detach this section (pages i–iv) and retain for your own records. i
 Codes to enter for questions 13–16
Refer to the lists below for the codes to enter for your country of nationality, your first language and
your occupation.
If either your first language or your country of nationality is not listed, enter ‘000’. Look for the closest
description of your occupation and proposed area of study. If your work or position is not covered at all,
then enter ‘00’.

Question 13 – Country of nationality

Afghanistan 001 El Salvador 058 Macedonia, the Former Yugoslav
Åland Islands 237 Equatorial Guinea 059 Republic of 225
Albania 002 Eritrea 060 Madagascar 116
Algeria 003 Estonia 061 Malawi 117
American Samoa 004 Ethiopia 062 Malaysia 118
Andorra 005 Falkland Islands 224 Maldives 119
Angola 006 Faroe Islands 063 Mali 120
Anguilla 238 Fiji 064 Malta 121
Antarctica 239 Finland 065 Marshall Islands 122
Antigua and Barbuda 007 France 066 Martinique 123
Argentina 008 French Guiana 067 Mauritania 124
Armenia 009 French Polynesia 068 Mauritius 125
Aruba 223 French Southern Territories 246 Mayotte 227
Australia 010 Gabon 069 Mexico 126
Austria 011 Gambia 070 Micronesia, Federal States of 228
Azerbaijan 012 Georgia 071 Moldova, Republic of 128
Bahamas 013 Germany 072 Monaco 129
Bahrain 014 Ghana 073 Mongolia 130
Bangladesh 015 Gibraltar 074 Montenegro 131
Barbados 016 Greece 075 Montserrat 132
Belarus 017 Greenland 076 Morocco 133
Belgium 018 Grenada 077 Mozambique 134
Belize 019 Guadeloupe 078 Myanmar 135
Benin 020 Guam 079 Namibia 136
Bermuda 021 Guatemala 080 Nauru 137
Bhutan 022 Guinea 081 Nepal 138
Bolivia, Plurinational State of 023 Guinea-Bissau 082 Netherlands 139
Bonaire, Sint Eustatius and Saba 240 Guyana 083 New Caledonia 141
Bosnia and Herzegovina 024 Haiti 084 New Zealand 142
Botswana 025 Heard Island and Nicaragua 143
Bouvet Island 241 McDonald Islands 247 Niger 144
Brazil 026 Holy See (Vatican City State) 212 Nigeria 145
British Indian Ocean Territory 242 Honduras 085 Niue 146
Brunei Darussalam 027 Hong Kong 086 Norfolk Island 229
Bulgaria 028 Hungary 087 Northern Mariana Islands 230
Burkina Faso 029 Iceland 088 Norway 147
Burundi 031 India 089 Oman 148
Cambodia 032 Indonesia 090 Pakistan 149
Cameroon 033 Iran, Islamic Republic of 091 Palau 231
Canada 034 Iraq 092 Palestine 150
Cape Verde 036 Ireland 093 Panama 151
Cayman Islands 038 Israel 094 Papua New Guinea 152
Central African Republic 039 Italy 095 Paraguay 153
Chad 040 Jamaica 097 Peru 154
Chile 041 Japan 098 Philippines 155
China (People’s Republic of) 042 Jordan 099 Pitcairn 156
Christmas Island 243 Kazakhstan 100 Poland 157
Cocos (Keeling) Islands 244 Kenya 101 Portugal 158
Colombia 043 Kiribati 102 Puerto Rico 159
Comoros 044 Korea, Democratic People’s Qatar 160
Congo 045 Republic of 103 Réunion 161
Congo, Democratic Korea, Republic of 104 Romania 162
Republic of the 219 Kosovo 235 Russian Federation 163
Cook Islands 046 Kuwait 105 Rwanda 164
Costa Rica 047 Kyrgyzstan 226 Saint Barthélemy 248
Côte d’Ivoire 096 Lao People’s Democratic Saint Helena, Ascension and
Croatia 048 Republic 106 Tristan Da Cunha 180
Cuba 049 Latvia 107 Saint Kitts and Nevis 181
Curaçao 245 Lebanon 108 Saint Lucia 182
Cyprus 050 Lesotho 109 Saint Martin (French Part) 249
Czech Republic 051 Liberia 110 Saint Pierre and Miquelon 183
Denmark 052 Libya 111 Saint Vincent and the Grenadines 184
Djibouti 053 Liechtenstein 112 Samoa 217
Dominica 054 Lithuania 113 San Marino 165
Dominican Republic 055 Luxembourg 114 Sao Tome and Principe 166
Ecuador 056 Macao 115 Saudi Arabia 167
Egypt 057 Senegal 168

ii
 Question 14 – First language
Serbia 169 Afrikaans 001 Maltese 074
Seychelles 170 Akan 002 Maori 075
Sierra Leone 171 Albanian 003 Marathi 076
Singapore 172 Amharic 004 Marshallese 077
Sint Maarten (Dutch Part) 250 Arabic 005 Masai 078
Slovakia 173 Armenian 006 Mende 079
Slovenia 174 Assamese 007 Mongolian 080
Solomon Islands 175 Aymara 008 Nepali 081
Somalia 176 Azeri 009 Norwegian 082
South Africa 177 Baluchi 010 Oriya 083
South Georgia and the Bambara 011 Palauan 084
South Sandwich Islands 251 Basque 012 Pashto 086
South Sudan 252 Bemba 013 Polish 087
Spain 178 Bengali 014 Ponapean 088
Sri Lanka 179 Bihari 015 Portuguese 089
Sudan 185 Bosnian 901 Punjabi 085
Suriname 186 Breton 016 Pushtu 090
Svalbard and Jan Mayen 232 Bulgarian 017 Quechua 091
Swaziland 187 Burmese 018 Rajasthani 092
Sweden 188 Byelorussian 019 Riff 093
Switzerland 189 Catalan 020 Romanian 094
Syrian Arab Republic 190 Chinese 021 Romansch 095
Taiwan 192 Creole 022 Russian 096
Tajikistan 233 Croatian 023 Samoan 097
Tanzania, United Republic of 193 Czech 024 Scottish Gaelic 138
Thailand 194 Danish 025 Serbian 098
Timor-Leste 222 Dari 026 Setswana 099
Togo 195 Dutch 028 Shona 100
Tokelau 196 Dzongkha 027 Sindhi 101
Tonga 197 Efik 029 Singhalese 102
Trinidad and Tobago 198 English 030 Slovak 103
Tunisia 199 Estonian 031 Slovene 104
Turkey 200 Ewe 032 Somali 105
Turkmenistan 234 Faeroese 033 Spanish 106
Turks and Caicos Islands 201 Farsi 034 Swahili 107
Tuvalu 202 Fijian 035 Swazi 108
Uganda 203 Filipino 904 Swedish 109
Ukraine 204 Finnish 036 Tagalog 110
United Arab Emirates 205 Flemish 037 Tahitian 111
United Kingdom 206 French 038 Tamil 112
United States of America 209 Fulani 039 Tatar 113
United States Minor Ga 040 Telugu 114
Outlying Islands 253 Galician 903 Tetum 136
Uruguay 207 Georgian 041 Thai 115
Uzbekistan 210 German 042 Tibetan 116
Vanuatu 211 Gilbertese 043 Tigrinya 117
Venezuela 213 Greek 044 Tongan 118
Vietnam 214 Gujarati 045 Trukese 119
Virgin Islands, British 236 Haitian Creole 046 Tulu 120
Virgin Islands, U.S. 208 Hausa 047 Tupi/Guarani 121
Western Sahara 216 Hebrew 048 Turkish 122
Yemen 218 Hindi 049 Uighur 123
Zambia 220 Hungarian 050 Ukrainian 124
Zimbabwe 221 Ibo/lgbo 051 Ulithian 125
Other 000 Icelandic 052 Urdu 126
Igala 053 Uzbek 127
Indonesian 054 Vietnamese 128
Irish 137 Welsh 139
Italian 055 Wolof 129
Japanese 056 Xhosa 130
Javanese 057 Yao 131
Kannada 058 Yapese 132
Kashmiri 059 Yiddish 133
Kazakh 060 Yoruba 134
Khmer 061 Zulu 135
Korean 062 Other 000
Kurdish 063
Lao 064
Latvian 065
Lithuanian 066
Luba 067
Luo 068
Luxemburgish 069
Macedonian 902
Malagasy 070
Malay 071
Malayalam 072
Malinka 073

Please turn over iii

 Question 15 – Occupation

Example
If you are a student, enter 08 because the sector
is Education and 7 because the level is Student.

0 8 7

Sector
Administrative Services 01
Agriculture, Fishing, Forestry, Mining 02
Arts and Entertainment 03
Banking and Finance 04
Catering and Leisure 05
Construction Industries 06
Craft and Design 07 Checklist
Education 08
Health and Social Services 09 I have signed the Application Form.
Installation, Maintenance and Repair Services 10
Law and Legal Services 11
Manufacturing and Assembly Industries 12
Personal Services 13 I have provided all the information required.
Retail Trade 14
Technical and Scientific 15
Telecommunications and the Media 16
Transport 17
I have paid the test fee.
Utilities (gas, water etc.) 18 (Please note that your application will not be
Wholesale Trade 19 processed ­without this.)
Other 00

Level
Self-employed 1
I have attached a photocopy of my passport /
Employer/Partner 2 National Identity Card (pages showing
Employee (Senior level) 3
Employee (Middle or Junior level) 4
personal identification details and expiry date).
Worker in the home 5
Retired 6
Student 7
Other 0

Question 16 –  Why you are taking the test

For higher education extended course 01
(three months or more)
For higher education short course 02
(three months or less)
For other education purposes 03
For registration as a doctor 04
For immigration 05
For employment 06
For professional registration (NOT medical) 07
For personal reasons 08
For registration as a nurse (including CGFNS) 09
For registration as a dentist 10
Other 00

iv * Important: Please detach this section (pages i–iv) and retain for your own records.
Applications to Recognising Organisations

22 Please give details below of academic institutions/government agencies/professional bodies/employers you would
24

like your result sent to. Add your file/case number if known. Results may be sent either electronically or by post to

these organisations. Please complete all details below for the centre to correctly identify Recognising Organisations.

The centre may charge a postal fee for results sent i­nternationally or by courier. The Test Report Form will not be

sent to migration or education agents. Please note that organisations you have listed below may access your results

before you have received or viewed them.

a) 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

Please turn over 3

 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 Assessment English (part of the University of Cambridge), collectively referred to as the IELTS
Test Partners.
2. I acknowledge that I have read the IELTS Information for Candidates booklet.
3. I acknowledge that I have read the ‘IELTS Notice to Candidates’ in this Application Form and agree to abide by the IELTS test terms and conditions.
4. I understand that there may be local terms and conditions that I must comply with and that the test centre will provide details of these on request.
5. I understand that if the details on this Application Form are not completed, my application may not be processed. I further understand that
completing and submitting this 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 by the test centre.
6. I certify that the information in my application is complete, true and accurate.
7. I understand that my test result cannot be used for United Kingdom Visas and Immigration (UKVI) application purposes and that I will not be eligible
for a refund if I subsequently find that I require an IELTS for UKVI test result.
Personal Information
I understand that:
8. It is necessary for my personal information to be collected and processed in order for me to take the IELTS test, to verify my identity and to receive
my results. This personal information is collected and securely stored when I apply for and when I take the IELTS test and is used by the IELTS Test
Partners for the purpose of the IELTS test.
9. My personal information, including, without limitation, test performance or score data and my test result may be disclosed by the IELTS Test
Partners to 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.
10. My personal information may be processed in an anonymous form by the IELTS Test Partners for statistical and research purposes.
11. My photograph will be taken by the test centre on test day and will appear on my Test Report Form. This photograph will be provided to any
Recognising Organisations or government authorities to which I apply, to allow these organisations to verify my test result.
12. I will be required to verify my identity on test day by providing the identity document specified by the test centre. I may also be requested to confirm
my identity on test day by having a finger scan taken. The finger scan is taken as a Binary Large Object (BLOB), and no image of my fingerprint will
be held. This biometric data will be held for 60 days after my test and will not be disclosed to any entity except the IELTS Test Partners.
13. My Speaking test will be recorded. In the event the test does not record I will be required to re-take the Speaking test. An observer may attend my
Speaking test as part of the examiner monitoring process.
14. I may be filmed for security and quality assurance purposes when registering for the test and during the test. The video footage will be for held for 60
days after my test and may be used for audit or investigation purposes.
15. I can access further details on how the IELTS Test Partners use my personal information (including how long it is retained in different circumstances
and how I can exercise my rights) at ielts.org/privacy.
Test Fees and Refunds
I understand that:
16. I will be charged the full test fee upon registration.
17. If I request a transfer or cancel my test, my right to a refund will be determined in accordance with local legislation.
Test Integrity, Security and Malpractice
I understand that:
18. I must attend all four test components in order to receive a test result and any exception to this must be approved in advance by the test centre.
19. The IELTS Test Partners have a responsibility to all candidates and Recognising Organisations to ensure the highest confidence in IELTS test results.
The IELTS Test Partners may therefore be required 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 any reason.
20. My test result may not be issued 13 days after the test if any of the IELTS Test Partners consider 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 may be required
to provide additional samples of my writing and speaking for the purposes of assisting any investigation before or after the test. In exceptional
circumstances I may be required to re-take one or more IELTS components.
21. 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 banned from taking the IELTS test in the future. If I am banned, I will receive a notification
stating the length of the ban. If I am subject to a ban and I register to take the test, I will not receive a test result and I will not be entitled to a refund.
If a result is issued to me while I am subject to a ban, this result will be cancelled and I will not be entitled to a refund.
22. Details of any proven or suspected malpractice may be provided to Recognising Organisations, including governments (including visa processing
authorities) and appropriate regulatory authorities, and centrally to the IELTS Test Partners. In instances where malpractice has been proven, I may
be liable to prosecution.
23. The work I produce in the IELTS test remains the property of the IELTS Test Partners and will not be released to me. In cases of proven or suspected
malpractice my work may be provided to relevant authorities.
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.
British Council, IDP: IELTS Australia and Cambridge Assessment English 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.

Signature Date d d m m y y

4 Copyright © UCLES 2018 | CER/6305/V1/SEP18