IELTS

Title

Firstname

Last name

Preferred date of test

Test city location

Phone Number

Zip/Postal code

Date of birth

Gender

Please indicate which document you will be using as proof of identity
(Candidates taking the test outside their own country must use a current passport. You must bring the ID document indicated below to the test. This is the only form of identity that will be accepted on the test day. The document must be valid/not expired at registration and on the test day.)

Pasport or National identity card #

National Identity card number

Passport number

IELTS test module are you taking?

Address

For office use only

Scheme

Date of payment

Test date

Receipt number

Administrator's initials

ID checked

AC GT

Please take care and enter this information accurately

Country of Nationality (code)

Country of Nationality (name)

First language (code)

Occupation (sector)

Occupation (level)

Why are you taking the test?

Which country are you applying to/intending to go to?

Where are you currently studying English (if applicable)?

What level of education have you completed?

How many years have you been studying English?

Do you have a permanent disability, such as a visual, hearing or specific learning difficulty which requires arrangements (for example, modified material, extra time, use of technology,etc.)?

If yes, please specify your requirements below. You must attach original supporting medical evidence to this form. The medical evidence must be in the form of a report prepared in a period no more than two years before the test date. You must submit requests for modified test materials at least three months before the test.

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