Please leave this field empty. SECTION 1 Family name Given name(s) Date of Birth Contact address Mobile E-mail SECTION 2 I intend to sit for the following paper-based examination: Pre A1 StartersA1 MoversA2 FlyersA2 KeyA2 Key for SchoolsB1 PreliminaryB1 Preliminary for SchoolsB2 FirstB2 First for SchoolsC1 Advanced (CAE)C2 Proficiency (CPE) ANY CHANGES ON EXAMINATION ENTERED CANNOT BE MADE AFTER COMPLETION OF THIS FORM. I certify that the information on this form is complete and accurate to the best of my knowledge. The examination fee cannot be refunded or transferred to another session. I agree to comply with the examining bodies’ regulations for the above exam and with the arrangements made by Normington Examination Centre, Bangkok. Disclaimer Normington Examination Centre and the Examining Boards take all reasonable steps to provide continuity of service. We feel sure you will understand, however, that we cannot be held responsible for any interruptions caused by circumstances beyond our control. If examinations or their results are disrupted, cancelled or delayed, every effort will be made to resume normal service as soon as possible. Normington Examination Centre’s liability will be limited to the refund of the registration fee or re-testing at a later date. Signature (please type) Date