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Affix your most recent passport size photo here (write your name at the back of the photo)


Centre Number Candidate Number

Have you taken the London examination before? YES / NO * (If YES, please provide the UCI number)

UCI (Unique Candidate Identification) Number

Given Name (in BLOCK letters)

Surname / Family Name (in BLOCK letters)

Correspondence Address (mandatory)

Passport/IC Number Home Telephone Number Gender*


Date of Birth (dd/mm/yyyy) Guardian Contact Number (mandatory for under-18)

Mobile Telephone Number

Email Address (mandatory)

Male / Female
* Please circle as appropriate

Normal registration period 7th January 2013 to 14th March 2013 Late registration period 15th March 2013 to 15th April 2013
Fees per Syllabus

Subject and Unit Code

(circle the Code you wish to register for)

Component and Option Code

(circle the Option code you wish to register for)

Accounting Arabic (First Language) Bangladesh Studies Bengali Biology Business Studies Chemistry

4AC0 4AR0 4BN0 4BE0 4B10R 4BS0 4CH0R

01: Accounting Paper 1 & 2 Paper 1 & 2 01: Bengali Paper 1 & 2 01: Business Studies Paper 1 & 2 01: Listening 02: Reading & Writing R R

RM720 RM720 RM720 RM720 RM720 RM720 RM720 RM720



01: Listening 02: Reading & Writing 03: Speaking A RM940 RM720 RM720 RM720 RM720

Classical Arabic Commerce Economics

4CA0 4CM0 4EC0

01: Classical Arabic 01: Commerce 01: Economics 01: Reading & Writing 02: Listening

English as a Second Language


01: Reading & Writing 02: Listening 03: Speaking A RM940

Subject and Unit Code

(circle the Code you wish to register for)

Component and Option Code

(circle the Option code you wish to register for)

Fees per Syllabus


English Language Specification A English Language Specification B English Literature

4EA0 4EB0 4ET0

Paper 1 & 2 Paper 1, 3 & 4 01: Specification B Paper 1 & 2 Paper 1 & 3 01: Listening 02: Reading & Writing



RM720 A B RM720 RM720



01: Listening 02: Reading and Writing 03: Speaking A RM940 RM720 RM720 RM720 RM720 RM720 RM720 RM720 FR HR RM720 RM720 RM720 RM720 R A A RM720 RM720 RM1,340 RM720 RM720

Further Pure Mathematics Geography German Gujarati History Human Biology Islamiyat Mathematics Specification A Mathematics Specification B Modern Greek Pakistan Studies Physics Religious Studies Science (Double Award) Sinhala

4PM0 4GE0 4GN0 4GU0 4H10 4HB0 4IS0 4MA0R 4MB0R 4MG0 4PA0 4PH0R 4RS0 4SC0R 4SI0

Paper 1 & 2 01: Geography 01: Listening 02: Reading and Writing 01: Gujarati 01: History Paper 1 & 2 01: Islamiyat Paper 1F & 2F Paper 3H & 4H Paper 1 & 2 01: Modern Greek Paper 1 & 2 Paper 1 & 2 01: Religious Studies Science Double Award (Biology, Chemistry, and Physics Paper 1) 01: Sinhala 01: Listening 02: Reading and Writing



01: Listening 02: Reading and Writing 03: Speaking A A A A A RM940 RM720 RM720 RM720 RM720

Swahili Tamil Turkish Urdu

4SW0 4TA0 4TU0 4UR0

01: Swahili 01: Tamil 01: Turkish 01: Urdu

Note: Coursework and Transferred Coursework options are not available to international private centre candidates. Private candidate may select the Written Alternative option available.

Summary of fees:Registration fee at RM100.00 per candidate (non-refundable) ______ no. of subjects x RM720.00 per subject ______ no. of subjects x RM940.00 per subject (for Language Subjects with Speaking Tests) ______ no. of subjects x RM1,340.00 per subject (Science Double Award) Late entry fees (15 March 2013 to 15 April 2013) RM140.00 per candidate (non-refundable) + ______ no. of IGCSE subjects x RM310.00 per subject Total IGCSE exam fee payable in Ringgit Malaysia to British Council RM
th th

RM100.00 RM RM RM


Declaration by Candidate 1. I make this entry according to the provisions of the published regulations which I have studied. 2. I agree that it is my responsibility to select the modular units that best meet my needs. 3. I have given all the information required truthfully and accurately to the best of my knowledge and belief. 4. I understand that I shall be allowed to sit only for those subjects and papers for which I have entered on this form. 5. I have not made any entry at any other CIE examination centre. 6. I have not made any entry at any other Edexcel examination centre. 7. I agree that there will be no postponement or refund of all fees should I decide to withdraw from the examination after registration. 8. I accept the responsibility to ascertain the place and date of the examination in case the official notification does not reach me on time Special Consideration: Access Arrangements Applications If you are a candidate with special requirements (Dyslexia, hearing difficulties etc.), please attach a medical report written in English to this application form. Candidates should make sure the report specifies the needs of the candidate for the examination (extra time, headphones etc.) Deadline for Access Arrangement Applications is 14th March 2013. F Please tick here if you need Access Arrangements.

Signature of candidate: _____________________________________ Date: ________________________ Disclaimer The British Council and the Examining Boards take all reasonable steps to provide continuity of service. We feel sure 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 Councils liability will be limited to the refund of the registration fee or re-testing at a later date.
For official use only

Amount paid Receipt Number

Date of payment

Registered by: . Your completed entry form must be accompanied by the following (please tick): F F F F A recent coloured passport size photograph affixed to the entry form A copy of your passport or Identify Card The total examination fee A medical report for Access Arrangements (if applicable)

Payment Details [payable to British Council] Kuala Lumpur and Penang centres: Payment can be made in cash, by cheque, bank draft, bank transfer, or credit card. Kuala Lumpur and Penang bank details: Bank: Citibank Bank swift code: CITIMYKL Account Number: 0-115889-028 [Cash deposit must be made through the Citibank counter and not via the cash machine (ATM machine). If you wish to pay by cheque deposit, you may drop the cheque into the corporate box at Citibank].

Note: For payment made by bank transfer, cash or cheque deposits please call the relevant test centre to obtain a reference code first.

You may hand or post the completed entry form to either of our offices which you are registering to sit the examination as shown below:British Council Ground Floor, West Block Wisma Selangor Dredging 142C Jalan Ampang 50450 Kuala Lumpur Tel. No.: 03 2723 7987 Fax No.: 03 2713 6599 E-mail: kualalumpur.exams@britishcouncil.org.my Opening times: Mondays to Fridays Saturdays & Sundays British Council Penang centre Wisma Great Eastern Suite 3A.1 & 3A.2 25 Light Street 10200 Penang Tel. No.: 04 263 0330 Fax No.: 04 263 3262 E-mail: penang.exams@britishcouncil.org.my Opening times: Tuesdays to Sundays

9.00am to 8.00pm 10.00am to 5.00pm

9.00am to 5.45pm

www.britishcouncil.org.my www.edexcel-international.org www.examzone.co.uk www.edexcelstudents.org.uk/club/