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Registration telc exam

Title*:


First name*:
Family name*:
Passport number:
Nationality*:
Date of birth*:
Native Town*:
Native Country*:
Native language*:
Address*:
ZIP, City*:
Phone:
E-Mail*:
Certificate:
Registration for telc exam*:
Name of the exam:
Examination date*:
I would like to take the exam on an extracurricular date (Only possible if several people register. Prices and conditions on request.):
Did you already sit this telc exam?:
I wish to repeat the exam:
Exam preparation:
I'm interested in having an exam preparation course.
In the case of minors, name of their legal guardian or legal representative :
Yes, I have read the General Terms and Conditions and I agree to them.*:

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