Indian Testing Board

Examination Registration Form

Name of Candidate Telephone Email

ITB Exam (Check One) Dates of Course (if any) Date of Exam
❏ Foundation
❏ Advanced
Form of Fee Payment: Name of Training Course (if any)
❏ Attached Check
❏ Draft (for Indian Testing Board Payable at Name of Training Company (if any)
NOIDA)
❏ Not Applicable (Company Pre-paid) Name of Training Instructor (if any)

Send results and certificate to (address):

Signature ________________________________ Date __________________

This form should be submitted with the completed exam, along with payment.

FOR PROCTOR USE ONLY

Proctor Name __________________________

Date of exam __________________________

Results
Points: ________ out of ________ total, ____ %. I, ______________________, administered

o Fail o Pass o Pass with distinction (>80%) this test to __________________________

Candidate informed of result: o Yes o No on _____________, and graded this test on

If no, reason: ___________________________ ________________, with the results shown.

______________________________________ Signature _____ ______________________

FOR OFFICE USE ONLY Results sent to candidate: o Yes o No

Received by __________________________ If no, reason: ________________________

Date of exam __________________________ Certificate sent to candidate: o Yes o No

If no, reason: ________________________