Choose your exam:

Paper Based:
Not applicableFCECAECPE

Computer Based (CB)
Not applicableFCE (CB)CAE (CB)CPE (CB)

Exam date:
View dates Cambridge Courses

Personal Details

First names (as in passport):

Last name:

Date of birth

Gender:
femalemale

Street and house number:

Postcode (e.g. 1234 AB):

City:

Telephone:

E-mail address:

Any special requirements due to medical conditions:
noyes

If 'yes', please describe below the relevant documents to your requirements.

Payment options:
Bank transferPin/cash at BLTC

Bank transfer to:
BLTC B.V.
IBAN: NL46ABNA0547679386
BIC: ABNANL2A (for international payments only)
Important! Please state: '[Cambridge exam] for [name], [test date] & [telephone number]'

Please note:
- credit cards are not accepted
- all bank charges are the responsibility of the applicant
- BLTC does not use 'acceptgiros'
- you are ONLY REGISTERED FOR AN EXAM DATE on receipt of your payment, payment must be received before the registration deadline or late entry fees will be incurred

Signing student
Your complete name:

Place:

Date:

Consent text, 18 or over

Declaration:
I wish to be admitted for a Cambridge ESOL exam at the centre listed on this form and for the date listed
here.

I will bring a valid photo ID with me on the test day, and I consent to have my photo taken by the centre on the day of the Speaking test and/or written papers. I agree for this photo to be held on the secure Cambridge ESOL Results Verification site, and the photo shall only be available to organisations/individuals that I give my details to or that I authorise to view my result via a download. I consent that these organisations/individuals can use these details to verify my examination result.

By signing this form I declare that I am aware of and agree to comply with the Terms and Conditions for
this examination.

Signing for consent
Your complete name:

Place:

Date:

By signing I agree to the “Terms and Conditions”.