PEARSON EDEXCEL INTERNATIONAL GCSE EXAMINATIONS (IGCSE)

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Centre Name PEARSON EDEXCEL INTERNATIONAL GCSE EXAMINATIONS (IGCSE) MAY/JUNE 2019 PHOTO Affix your most recent passport size photo here (write your name at the back of the photo) FOR OFFICE USE ONLY

1 Centre Name PEARSON EDEXCEL INTERNATIONAL GCSE EXAMINATIONS (IGCSE) MAY/JUNE 2019 PHOTO Affix your most recent passport size photo here (write your name at the back of the photo) FOR OFFICE USE ONLY Have you taken the examination before? YES / NO * (If YES, please provide the UCI number) UCI (Unique Candidate Identification) number Centre Number / Candidate Number Given Name (in BLOCK letters as per identity document) B Surname / Family Name (in BLOCK letters as per identity document) Current School Name School Address Education Level Full Address (for correspondence) Passport/IC Number Nationality Date of Birth (DD/MM /YYYY) Home Telephone Number Mobile Telephone Number Guardian Contact Number (MANDATORY for candidates below 18 years old) Gender Address (MANDATORY) May/June 2018 Examinations Registration Deadlines Normal Registration Closing Date 28 February 2019 First Stage Late Entry 01 March March 2019 Second Stage Late Entry 25 March April 2019 Checklist: Your completed entry form must be accompanied by the following (please tick): A recent coloured passport size photograph affixed to the entry form A copy of your passport or Identity Card The total examination fee A medical report for Access Arrangements (if applicable) Special Consideration: Access Arrangements Applications If you are a candidate with special requirements (Dyslexia, hearing difficulties etc.), please attach a medical report written in English to this application form. Candidates should make sure the report specifies the needs of the candidate for the examination (extra time, headphones etc.) Please tick here if you need Access Arrangements (please attach a supporting letter from a registered medical practitioner) V.1 Page 1

2 Subject and Unit Code (circle the Code you wish to register for) Component and Option Code (circle the Option code you wish to register for) (Standard) (Low late fee) (High late fee) Accounting 4AC1 Paper 1 & 2 R Arabic (First Language) 4AA1 Paper 1 & Art and Design: Fine Art 4FA1 Paper 1 & Bangladesh Studies 4BN1 Paper 1 & Biology 4BI1 Paper 1 & 2 R Business 4BS1 Paper 1 & 2 R Chemistry 4CH1 Paper 1 & 2 R Chinese (Mandarin) 4CN1 Paper 1, 2 & 3 AR Commerce 4CM1 Paper 1 & 2 R Economics 4EC1 Paper 1 & 2 R English as a Second Language 4ES1 Paper 1 & 2 R English Language Specification A 4EA1 Paper 1 & 2 AR English Language Specification B 4EB1 Paper 1 R English Literature 4ET1 Paper 1 & Paper 2 AR Further Pure Mathematics 4PM1 Paper 1 & Geography 4GE1 Paper 1 & 2 R Global Citizenship 4GL1 Paper Greek (first language) 4GK1 Paper 1 & Paper Gujarati 4GU0 Paper History 4HI1 Paper 1 & Human Biology 4HB1 Paper 1 & 2 R Islamic Studies 4IS1 Paper Mathematics Specification A 4MA1 Paper 1FR & 2FR Paper 1HR & 2HR FR HR Mathematics Specification B 4MB1 Paper 1 & 2 R Pakistan Studies 4PA1 Paper 1 & Physics 4PH1 Paper 1 & 2 R Religious Studies 4RS1 Paper 1 & Science Single Award 4SS0 Biology paper 1, Chemistry paper 1 & Physics paper Science Double Award 4SD0 Biology paper 1, Chemistry paper 1 & Physics paper 1 R Sinhala 4SI1 Paper Tamil 4TA1 Paper Turkish 4TU0 Paper V.1 Page 2

3 BREAKDOWN OF EXAMINATION FEES Total International GCE exam fee payable in Ringgit to RM CANDIDATE DECLARATION 1. I make this entry according to the provisions of the published regulations which I have studied. 2. I agree that it is my responsibility to select the modular units that best meet my needs. 3. I have given all the information required truthfully and accurately to the best of my knowledge and belief. 4. I understand that I shall be allowed to sit only for those subjects and papers for which I have entered on this form. 5. I have not made an entry at any other Examination centre. 6. I have not made any entry at any other Examinations centre. 7. I agree that there will be no postponement or refund of all fees should I decide to withdraw from the examination after registration. 8. I accept the responsibility to ascertain the place and date of the examination in case the official notification does not reach me on time CONSENT FOR EXAMINATION I, the undersigned, hereby agree and authorize the to disclose my personal data, such as my name, date of birth, gender, ID/Passport No., and information pertaining to this application to Pearson ( ) for purpose of providing and registering IGCSE/GCE O-Level/AS/A-Level examinations. I understand that any personal data provided by the to shall also be subject to s privacy policy. Signature of candidate: Date: Signature of legal guardian: ( for the under-18 s) For official use only Amount Paid Receipt Number Date of Payment Registered By Disclaimer The 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 s liability will be limited to the refund of the registration fee or re-testing at a later date. V.1 Page 3

4 PAYMENT OPTIONS Transaction shall be made payable to BRITISH COUNCIL Office Submit to Cash Credit Card Bank Transfer Kuala Lumpur KL Office Penang Penang Office Terms of fee and payment: 1. Payment can be made to the either by cash, cheque, credit card, bank draft, or bank transfer. 2. Payment made to the respective office is subject to Bank s transaction terms and conditions. 3. Registration will be processed upon receipt and validation of the copy of the remittance slip which may be submitted by hand/courier together with the application form. 4. Payment via cash deposit must be made through the Citibank counter and not via a Cash Deposit Machine. 5. Payment description must be stated clearly. Bank Details: Payment Description : EDEXCEL MAY/JUNE2019 (Candidate s Name) Bank : Citibank Bank Swift Code : CITIMYKL Account Number : Completed application form is to be submitted by hand/courier to the office which you are registering to sit the examination as shown below: Ground Floor, West Block Wisma Selangor Dredging 142C Jalan Ampang Kuala Lumpur Tel. No.: Fax No.: kualalumpur.exams@britishcouncil.org.my Counter opening times: Mondays to Fridays 9.00 am to 7.00 pm Saturdays & Sundays am to 4.00pm Penang Centre Wisma Great Eastern Suite 3A.1 & 3A.2 25 Light Street Penang Tel. No.: Fax No.: penang.exams@britishcouncil.org.my Opening times: Tuesdays to Sundays 9.00 am to 5.45 pm V.1 Page 4

5 Dear Parents/Guardians, Child Safe Collection Policy takes the safety of your child seriously. Our current Child Safe Collection Policy states that: Children aged up to 10 years are not permitted to leave the premises alone. Teenagers aged years should only be permitted to leave the premises alone if parental consent to this has been given in writing. [Kindly complete and return the Consent Form below]. Otherwise, they must be collected by the parent or by a person for whom the parent has provided written authorisation. [Kindly contact us for alternate arrangement on a case-by-case basis.] Thank you. Yours truly, Examination Services Consent Form I, (NRIC/Passport number: ), the parent/legal guardian of candidate hereby consent to my child/charge leaving the premises on his/her own after the examination. Yours truly, Name: Date: V.1 Page 5

INTERNATIONAL GCSE EXAMINATIONS (IGCSE) JANUARY 2019

PEARSON EDEXCEL Centre Name INTERNATIONAL GCSE EXAMINATIONS (IGCSE) JANUARY 2019 PHOTO Affix your most recent passport size photo here (write your name at the back of the photo) FOR OFFICIAL USE ONLY Centre