Professional Documents
Culture Documents
Refer to the Notes for Guidance. If you are unsure about an answer, please telephone for clarification. 1. Exam series: (Choose from January : March : May/June : November) 2. Full name, as shown on your birth (or marriage) certificate or passport: Title (Mr/Mrs/Miss) ____ First name(s) ___________________ Surname _______________________ 3. Gender: Male / Female: Date of Birth___/___/___ 4. Email address _________________________ 5. Address __________________________________________________________________________ _________________________________________________ Postcode _______________ 6. Home Telephone number ________________________ Mobile number _______________________ 7. Have you taken exams at Macclesfield Tutorial College before? Yes / No. If yes: dates __________ Month _________ 201__
8. Unique Candidate Identifier (UCI) _______________________________________________________ 9. If following a distance learning course: Organisation_________________ Telephone ______________ 10. Names of centres, with centre number if known, where you have taken exams before, . _________________________________________________________________________________ 11. Any special requirements (extra time/access) _____________________________________________
SUBJECT 1 SUBJECT 2 SUBJECT 3 Office use only
12 13 14
Subject
Title / Name
C.Number
Level:
GCSE/ IGCSE/ GCE AS / GCE A2
Exam Board
AQA / OCR / Edexcel / WJEC
Recd
Admin Fee
PCCIF
16 17
Board
18 19 20 21
T/Table
Photo ID
SoE sent
PLEASE COMPLETE FULLY AND RETURN THESE 2 PAGES TO MACCLESFIELD TUTORIAL COLLEGE
1. IDENTIFICATION
Please include with this application: 1. two passport-style/size photographs (no photocopies) of yourself. The reverse of the photographs must by signed and dated by a teacher or other professional person with the words This is a true likeness of (your name). 2. a brief, dated letter from a referee i.e. a teacher or other professional person, showing their name, address and telephone number, which confirms your identity. These must accompany your application form. Please note that the examination boards also require you to bring photographic identification - passport or photo driving licence - with you for each examination. Please give details of your referee who has provided confirmation of your identity: Name of referee ____________________________________________ Email __________________________________________________
For office use only
Address __________________________________________________ ____________________________ Postcode _____________ Home telephone number ________________ Mobile _______________
2. DECLARATION
In submitting this application for examination entry I agree to accept the terms and conditions of Macclesfield Tutorial College. Signed (Candidate) ____________________________________ Date ____________________ For candidates under 18 years of age, the section below should also be completed by a responsible adult. In submitting this application for examination entry I agree to accept the terms and conditions of Macclesfield Tutorial College. Name Email _________________________________________ Parent / Carer / Guardian (please delete) _______________________________________________________________________
Address _______________________________________________________________________ _____________________________________ Postcode _________________________ Home telephone number ________________________ Mobile telephone __________________ Signed _____________________________________ Date ___________________________
PLEASE COMPLETE AND RETURN THESE 2 PAGES TO MACCLESFIELD TUTORIAL COLLEGE 20 CUMBERLAND STREET, MACCLESFIELD, CHESHIRE, SK10 1DD Please complete all sections / boxes; write not applicable (N/A) where a section does not apply to you. Incomplete forms will be returned to you, which will result in a delay in processing your entry. (KEEP A COPY OF THIS APPLICATION FORM FOR YOUR RECORDS)