2022 Cambridge English Exam Booking Form
Please complete the following form to start the booking process.

In order to secure your booking, the exam fee must be paid, in full, to the following account:
CBE Languages Rotterdam
NL85RABO0311856144
BIC RABONL2U
Description: Your surname, the exam you are paying for, the date of the exam (e.g Gill-C1Adv-19/06/22)

Once payment has been made, our cancellation terms are as follows:
- Cancellation BEFORE deadline: no fee
- Cancellation AFTER deadline WITH valid/medical reason*: Credit note will be provided so you can take the exam at a later date.
- Cancellation AFTER deadline with NO valid/medical reason: Full exam fee payable - no refund or credit note provided.

To avoid incurring any late adjustment fees, please fill in the form as carefully and as accurately as possible.

*Once payment has been made, and the deadline has passed, it is no longer possible for you to receive a monetary refund upon cancellation. If you are unable to take the exam due to illness or other significant reason, you will need to submit a medical certificate from a registered medical practitioner and/or contact our exams manager with details. Cambridge English will evaluate the circumstances and if they are accepted, you will be issued a credit note. This credit note entitles you to take the same exam at a date in the future when you have recovered from your illness.

Your completion of this form indicates to CBE Languages that you have read, understood and accepted the following terms.

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Email *
In which exam are you interested? *
If you wish to register for an A2 KET, B2 PET or Delta Module 1 exam, please send an email to cambridge@cbelanguages.nl
What is your full first name? Write it as it appears on your passport and driving license. Write your first name and middle names e.g. Johan Eric   *
What is your surname / family name? Please write it in full (no abbreviations) E.g. van der Hoeven *
Please state your gender *
It is preferable that the option you select matches your identification, but we are sensitive to gender matters, so if there are any inconsistencies, please contact our director of studies, Emma. We will deal with these situations with the highest level of confidentiality.
What is your birthdate? Write day - month - year e.g. 27 - Jan - 1981 *
NOTE! Please write the month as a word NOT a number
Which email address would you prefer us to submit to Cambridge Assessment English? Note: Your confirmation of Entry and Results password will be sent to the email address you provide. *
What is your telephone number? *
Do you have any physical or learning difficulties that would require modified materials or extra time during the exam? If so - please send official proof of your condition to Emma at cambridge@cbelanguages.nl at least 6 weeks before the exam date. *
All documentation will be treated confidentially.
If you answered yes to the question above, please provide more details:
Are you interested in taking an exam preparation course? *
Have you taken down the bank details at the top of this form in order to send the payment?
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