Candidate Enquiries on Results and Complaints Procedure

1) Please enter your centre number below:

Please tick the appropriate boxes below

2) Which Cambridge course are you following?

Delta Module 1

Delta Module 2

Delta Module 3

CELTA

YL ext. to CELTA

3) Please indicate the importance to you of each of the following in entering for this award.

Employment in your country

In other countries

Promotion in your country

In other countries

Career prospects in your country

In other countries

Employer’s requirement

For international recognition

For professional development

4) Have you entered for this award before?

No Once More than once

5) What other recognised language teacher training have you undertaken (not including this course)?

TKT Module 1 ICELT

TKT Module 2 Delta Module 1

TKT Module 3 Delta Module 2

TKT: KAL Delta Module 3

TKT: CLIL

Other (please write here)

6) Are you qualified, in your country, to teach:

yes no

English?

Other subjects?

7) Do you have any ELT experience?

No Less than 1 year

1-2 years 2 years or more

8) Do you intend to teach:

yes no

In a private institution?

In a state institution?

9) Which of the following do you:

a) currently teach and/or

b) plan to teach?

a b

General English

English for:

Academic purposes

Business

Other specific purposes

10) What age range(s) do you:

a) currently teach and/or

b) plan to teach?

a b

5 to 11

11 to 16

16 to 18

adult

11) How old are you?

18 to 20 21 to 25 26 to 30

31 to 35 36 to 40 41 to 50

51 to 60 over 60

12) Are you:

Female? Male?

13) What level of education have you completed?

Further education

Higher education (e.g. first degree)

Post-graduate education (e.g. M.A.)

14) How did you find out about the Cambridge awards?

Personal recommendation

Language school / college

Library / careers centre

Advert (in )

Other

15) If you have an email address and would be willing to take part in a project to track career paths, please give your email address:

The answers you give on this sheet will not affect your result in any way

Which is your country of origin?

(If not listed, please tick “Other”.)

This listing implies no view regarding questions of sovereignty or status

£ Afghanistan

£ Albania

£ Algeria

£ American Samoa

£ Andorra

£ Angola

£ Anguilla

£ Antarctica

£ Antigua and Barbuda

£ Argentina

£ Armenia

£ Aruba

£ Australia

£ Austria

£ Azerbaijan

£ Bahamas

£ Bahrain

£ Bangladesh

£ Barbados

£ Belarus

£ Belgium

£ Belize

£ Benin

£ Bermuda

£ Bhutan

£ Bolivia

£ Bophuthatswana

£ Bosnia and Herzegovina

£ Botswana

£ Bouvet Island

£ Brazil

£ British Indian Ocean Territory

£ Brunei Darussalam

£ Bulgaria

£ Burkina Faso

£ Burundi

£ Cambodia

£ Cameroon

£ Canada

£ Cape Verde

£ Cayman Islands

£ Central African Republic

£ Chad

£ Chile

£ China, People's Republic of

£ Christmas Island

£ Cocos (Keeling) Islands

£ Colombia

£ Comoros

£ Congo

£ Congo (Zaire), The Democratic Republic of the

£ Cook Islands

£ Costa Rica

£ Côte D'Ivoire

£ Croatia

£ Cuba

£ Cyprus

£ Czech Republic

£ Denmark

£ Djibouti

£ Dominica

£ Dominican Republic

£ Ecuador

£ Egypt

£ El Salvador

£ Equatorial Guinea

£ Eritrea

£ Estonia

£ Ethiopia

£ Falkland Islands (Malvinas)

£ Faroe Islands

£ Fiji

£ Finland

£ France

£ French Guiana

£ French Polynesia

£ French Southern Territories

£ Gabon

£ Gambia, The

£ Georgia

£ Germany

£ Ghana

£ Gibraltar

£ Greece

£ Greenland

£ Grenada

£ Guadeloupe

£ Guam

£ Guatemala

£ Guinea

£ Guinea-Bissau

£ Guyana

£ Haiti

£ Heard Island and McDonald Islands

£ Honduras

£ Hong Kong

£ Hungary

£ Iceland

£ India

£ Indonesia

£ Iran, Islamic Republic of

£ Iraq

£ Irish Republic

£ Israel

£ Italy

£ Jamaica

£ Japan

£ Jordan

£ Kazakhstan

£ Kenya

£ Kiribati

£ North Korea

£ South Korea

£ Kuwait

£ Kyrgyzstan

£ Lao People's Democratic Republic

£ Latvia

£ Lebanon

£ Lesotho

£ Liberia

£ Libyan Arab Jamahiriya (Libya)

£ Liechtenstein

£ Lithuania

£ Luxembourg

£ Macao

£ Macedonia, The former Yugoslav Republic of

£ Madagascar

£ Malawi

£ Malaysia

£ Maldives

£ Mali

£ Malta

£ Marshall Islands

£ Martinique

£ Mauritania

£ Mauritius

£ Mayotte

£ Mexico

£ Micronesia, Federated States of

£ Moldova, Republic of

£ Monaco

£ Mongolia

£ Montenegro

£ Montserrat

£ Morocco

£ Mozambique

£ Myanmar (Burma)

£ Namibia

£ Nauru

£ Nepal

£ Netherlands

£ Netherlands Antilles

£ New Caledonia

£ New Zealand

£ Nicaragua

£ Niger

£ Nigeria

£ Niue

£ Norfolk Island

£ Northern Mariana Islands

£ Norway

£ Oman, Sultanate of

£ Pakistan

£ Palau

£ Palestinian Territory, Occupied

£ Panama

£ Papua New Guinea

£ Paraguay

£ Peru

£ Philippines

£ Pitcairn

£ Poland

£ Portugal

£ Puerto Rico

£ Qatar

£ Réunion Island

£ Romania

£ Russia

£ Rwanda

£ Samoa

£ San Marino

£ Sao Tome and Principe

£ Saudi Arabia

£ Senegal

£ Serbia

£ Seychelles

£ Sierra Leone

£ Singapore

£ Slovakia

£ Slovenia

£ Solomon Islands

£ Somalia

£ South Africa

£ South Georgia and the South Sandwich Islands

£ Spain

£ Sri Lanka

£ St Helena

£ St Kitts and Nevis

£ St Lucia

£ St Pierre and Miquelon

£ St Vincent and the Grenadines

£ Sudan

£ Suriname

£ Svalbard and Jan Mayen

£ Swaziland

£ Sweden

£ Switzerland

£ Syrian Arab Republic (Syria)

£ Taiwan, Province of China

£ Tajikistan

£ Tanzania, United Republic of

£ Thailand

£ Timor-Leste (East Timor)

£ Togo

£ Tokelau

£ Tonga

£ Trinidad and Tobago

£ Tunisia

£ Turkey

£ Turkmenistan

£ Turks and Caicos Islands

£ Tuvalu

£ Uganda

£ Ukraine

£ United Arab Emirates

£ United Kingdom

£ United States Minor Outlying Islands

£ United States of America

£ Uruguay

£ Uzbekistan

£ Vanuatu

£ Vatican City State

£ Venezuela

£ Vietnam

£ Virgin Islands, British

£ Virgin Islands, U.S.

£ Wallis and Futuna

£ Western Sahara

£ Worldwide

£ Yemen Arab Republic

£ Zambia

£ Zimbabwe

Other (write below)

This listing implies no view regarding questions of sovereignty or status

Which is your first language? (i.e. your mother tongue)

£ 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

£ Finnish

£ Flemish

£ French

£ Fulani

£ Ga

£ Georgian

£ German

£ Gilbertese

£ Greek

£ Gujarati

£ Haitian Creole

£ Hausa

£ Hebrew

£ Hindi

£ Hungarian

£ Ibo/lgbo

£ Icelandic

£ Igala

£ Indonesian

£ Italian

£ Japanese

£ Javanese

£ Kannada

£ Kashmiri

£ Kazakh

£ Khmer

£ Korean

£ Kurdish

£ Lao

£ Latvian

£ Lithuanian

£ Luba

£ Luo

£ Luxemburgish

£ Malagasy

£ Malay

£ Malayalam

£ Malinka

£ Maltese

£ Maori

£ Marathi

£ Marshallese

£ Masai

£ Mende

£ Mongolian

£ Montenegrin

£ Nepali

£ Norwegian

£ Oriya

£ Other

£ Palauan

£ Pashto

£ Polish

£ Ponapean

£ Portuguese

£ Punjabi

£ Pushtu

£ Quechua

£ Rajasthani

£ Riff

£ Romanian

£ Romansch

£ Russian

£ Samoan

£ 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

£ Wolof

£ Xhosa

£ Yao

£ Yapese

£ Yiddish

£ Yoruba

£ Zulu