Completing the IELTS Application Form

1. Preferred Date of Test:
   Include two preferred test dates. A list of dates appears on the IELTS Information Sheet.
2. Family Name:
   PRINT your legal family name (or last name) in the space available. (This name must be the same as the name on your national identity document.)
3. Title:
   CIRCLE the appropriate title.
4. Other Names:
   PRINT your first name and second name(s) in full. (These names must be the same as the names on your national identity document.)
5. Address for Correspondence:
   PRINT your street number, street name, apartment/unit number, city, province and postal code. If there is a buzzer number at your apartment building, please include this as well.
6. Telephone Number
   Include a telephone number where you can be reached during the day.
7. Fax Number:
   Please provide a fax number ONLY if available.
8. Email Address:
   Please provide an email address. Please note that our primary means of delivering information is via email.
9. Date of Birth:
   Indicate your date of birth (please ensure that the year is correct).
10. Gender: Please mark Male or Female
    CIRCLE the appropriate gender.
11. ID Document/ID Document Number:
    Evidence of identity is required. This must be a valid passport. CIRCLE the appropriate identification section and enter the number of your passport    in the space available. (Please be aware that you MUST include a copy of your passport with your completed application form, and bring your passport on the day of your test.)
12. Country of Origin:
    PRINT your nationality in the space available. Enter the code in the appropriate boxes. (Codes can be found in the back of the IELTS Handbook)
13. First Language:
    PRINT your first language in the space available. Enter the code in the appropriate boxes. (Codes can be found in the back of the IELTS Handbook)
14. Occupation (Sector) / (Level):
    Look for the closest description of your occupation and level. If your work and position is not covered at all, enter 000. Enter the code in the appropriate boxes. (Codes can be found as above.)
15. Why are you taking this test?
    Select the correct number code and enter in the appropriate box. (Codes can be found as above.)
16. Which country are you applying/intending to go to?
    Respond to this question only if you are applying to another country. Otherwise, leave this section blank.
17. Which IELTS Module are you taking?
    CIRCLE as appropriate.
    The Academic Reading and Writing Modules assess whether a candidate is ready to study or train in the medium of English at an undergraduate or postgraduate level. Admission to undergraduate and postgraduate courses should be based on the results of Academic modules.
    The General Training Reading and Writing Modules are not designed to test the full range of formal language skills required for academic purposes. The emphasis of General Training is on basic survival skills in a broad social and educational context. This module is suitable for candidates who are going to English-speaking countries to complete their secondary education, to undertake work experience or training programs not at a degree level, or for immigration purposes.
18. Which IELTS test are you taking?
    At this time at inlingua®, we currently only offer the paper-based test. All parts of the test will be paper-based.
19. Have you taken IELTS before?
    CIRCLE as appropriate.
20. Most recent test details:
    This should be completed only if you have taken the IELTS test before. Otherwise, leave this section blank.
21. What level of education have you completed?
    CIRCLE as appropriate.
22. How many years have you been studying English?
    CIRCLE as appropriate.
23. Name of College/University/Other Institution you would like results sent to:
    PRINT the name and the complete address of the college/university/other institution you would like your test results sent to. (Please note: you may request information sent to up to two institutions at no charge. For additional institutions, please include the processing fee of $10.00 per institution.)
24. Do you have any special needs?
    Descriptions of accommodation for special needs can be found on page 13 in the IELTS Handbook. Please note that 3 months notice is required for these needs to be accommodated.

    Final steps
    Attach a current ‘head and shoulders’ photograph in the space provided at the top of the Application Form. Please do not attach a photocopy or digitally enhanced photograph. Sign and date the Application Form. Include a copy of your passport together with your application. This is extremely important! Your application will ONLY be processed after we have a copy of your passport.

    Forms of payment:
    A. Credit cards: Visa, Master, American Express, or Discover.
    B. Other: money order or cashier/certified check in US funds.

    Where to send the completed IELTS Application Form together with payment:
    IELTS Administrator
    Inlingua English Center
    1901 N Moore St Suite LL-01
    Arlington, VA 22209