Cambridge International Examinations Registration Form

British Council, PO Box 30222 Capital City, Lilongwe 3, Malawi T +265 (0)1 773 244 CAMBRIDGE INTERNATIONAL PRIMARY PROGRAMME F +265 (0)1 772 945 REGISTRATION FORM www.britishcouncil.org/malawiPHOTO

April/May 2017 Session Form No……..…………

Please note that registration for the May/June session starts on 11 December 2017 and closes on 14th February 2018

Indemnity:

1. Please fill in all your particulars including the reliable contact addresses and telephone numbers. Your contact details below will be used in all correspondence with you. 2. The British Council will not be held responsible for loss or damage to documents sent by post. 3. Please note that certificates and statements of results will be sent to candidates except where prior arrangement has been made by the candidate with the British Council. 4. Candidates may authorise relatives or friends to collect statements of results and certificates on their behalf by submitting a signed letter plus their identities. 5. The British Council will not be held responsible for the loss of documents, certificates and statement of results collected on their behalf by the authorised friends and relatives. 6. Replacements of lost certificates and statements of results attract a fee. Please contact us for fee details and procedures on how to obtain replacement certificates and results from Examination Boards. 7. Refund of fees will only be made if British Council are notified of the withdrawal of candidate before the published entry closing date. All claims will attract a refund fee of 20% of the total fees paid to the British Council. 8. Each candidate is required to submit a passport size photo, which must be attached to this application and submitted together with the payment. 9. It is the responsibility of candidates to ensure that they fill in the correct codes subjects, units and modules they would like to take. 10. Please select the venue where you would like to write the examinations. British Council has the right to change venues but candidates affected will be notified before the exams are held. 11. Payment of fees to the British Council is confirmation of acceptance of these terms and conditions. Payment must be made directly into British Council bank account at Standard Bank - Capital City Branch - Account No. 9100001576213 12. Candidates requiring special assistance to enable them take their exams e.g. disabled are kindly requested to notify the exams department of the British Council in advance

Declaration by the principle/headmaster:

 I make this entry according to the provisions of the published regulations, which I have studied.  I have given all the information required truthfully and accurately to the best of my knowledge and belief.  I understand that I shall be allowed to sit only for those subjects and papers for which I have entered on this form.  I have not made an entry at another centre.

Signature of principle/headmaster (Mr/Mrs/Miss/Ms) ______Date: ______

A. Candidate personal details in Capital Letters

1. Surname 2. Other Names

3. Gender 4. Date of Birth 5. Please choose the venue convenient to you by (Circle it) (Please tick) F M Date Month Year Blantyre Zomba Lilongwe Mzuzu

6. Please indicate school where you are currently studying:

7. Contact Address (parent’s/guardian’s):

10. Telephone: 11. E-mail:

B. This section must be filled by candidate’s principle/headmaster (Please consult subject entry guide below)

Syllabus Name Syllabus Option Component Code Code Code C. This section will be filled by British Council staff only

Registration Fee Paid (MK) Date paid

Declaration by British Council officer

For the purposes of preventing impersonation in the examination I have examined documentary evidence of the kind indicated above and am satisfied as to the true identity of the person making this examination entry.

Signature: ______Date: ______

D. CIPP subject entry guide

Syllabus Name and Code Component Information Duration Option Code Notes

English 1: CIPAT English Paper 1 1 hr 0841 2: CIPAT English Paper 2 Option Code Components Leave Blank 1, 2

Mathematics 1: CIPAT Mathematics Paper 1 1 hr 0842 2: CIPAT Mathematics Paper 2 Option Code Components Leave Blank 1, 2,

Science 1: CIPAT Science Paper 1 1 hr 0843 2: CIPAT Science Paper 2 Option Code Components Leave Blank 1, 2

Fees for Primary Check point - £31.04 Secondary Checkpoint - £43.51

Disclaimer: The British Council and the examining boards take all reasonable steps to provide continuity of service. We feel 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 retesting at a later date.