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UNIVERSITY OF LONDON EXAM

REGISTRATION FORM – OCT/NOV2016

Write your Validation Code here

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Attach your passport

photographs here

2 PASSPORT PHOTOS REQUIRED

We need accurate information to be able to contact you at short notice. Please ensure that your details are correct

1.Family Name ______

2.Other name(s)______

(These names MUST be the same as the names on your national identity document)

  1. P O Box ______Code______Town______
  1. Mobile phone number.______(Ensure this is accurate - We may use your phone number to send you SMS with details about your exam, or last minute changes.)
  1. Date of Birth _____/______/______Sex F / M (circle as appropriate)

6. E-mail address ______

Nationality______

Do you have any special needs due to health/medical conditions? ______

If yes, please specify your requirements below and ask to see our leaflet on Special Arrangements. You will need to submit medical reports etc. Kindly see our Customer Services Officers

______

NOTE: FOR REFUNDS, PLEASE ASK TO SEE OUR REFUNDS POLICY. UOL payments CANNOT be carried forward to the next session. Kindly request a refund for any overpayments etc within the deadlines indicated in the Refund Policy. It is your responsibility to apply for any refunds

Disclaimer

The British Council 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. The British Council’s liability will be limited to the refund of the registration fee or re-testing at a later date.

Kindly note that electronic equipment etc are not allowed into the building.

Candidate’s Signature ______Date______
For Office use only
a)______papers @ ______= ______
Validation code issued by ______
Date:______/ Date of Exam _____/______/_____
Date of Payment _____/_____/_____
Amount Paid______

14.08.2016