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, under 18

Declaration:
I am the parent/legal guardian of the candidate named on this form and the candidate and I give consent to this person taking the Cambridge ESOL exam.

I understand that all individuals who want to take Cambridge ESOL exam are required to agree to all of the Terms and Conditions as mentioned on the Cambridge ESOL website.

I confirm that I have carefully reviewed the Terms and Conditions, including but not limited to, the provision of a valid photo ID for the exam day and that a photo will be taken of the candidate on the day of the test and will be stored on Cambridge ESOL’s secure Results Verification website. I understand and accept that the photo shall only be available to organisations/individuals that the candidate gives their details to. I consent that these organisations/individuals can use these details to verify the candidate’s examination result.

By signing this form, I consent to and agree that the candidate listed on this form will comply with all the Terms and Conditions of the Cambridge ESOL exam at this centre.

Signing Parent/Guardian
Your complete name:

Place:

Date:

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