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Completing the ielts application form
Instructions for Completing the IELTS Application Form
(Please PRINT legibly)
1 Preferred Date of Test:
preferred test dates (in day-month-year word order). A list of dates appears on
“Test Dates” page of the Information sheet and on our website. If two dates are not included, and your first choice is
full, there may be a delay while we attempt to contact you to confirm another test date. This could result in missing the next possible test date.
CIRCLE and write in the appropriate title (Mrs./Mr./Ms., etc.)
3 Family Name:
PRINT your legal family name (last name) in the space available. (This name must be the same as on
the identification you are providing for registration, i.e. a valid passport or a Canadian Permanent Resident Card)
4 Other Names:
PRINT your first name and all other name(s) in full. (This name must be the same as on the
identification you are providing for registration, i.e. a valid passport or a Canadian Permanent Resident Card)
5 Address for Correspondence:
PRINT your street number, street name, apartment/unit number, city, province/state
and postal/zip code. If there is a buzzer number
at your apartment building, please include this as well.
6 Telephone/Mobile Number:
Include a telephone number where you can be reached during the day.
7 E-mail Address:
Please provide a valid e-mail address. Please note that our primary means of delivering information
is via e-mail, so this is very important. NOTE: ‘hotmail.com
’ e-mail account users (and some others) – please check
your “junk” or “spam” mail.
8 Date of Birth:
Indicate your date of birth (in day-month-year word order).
CIRCLE the appropriate gender.
10 Identity Document and Identity Card Number:
Evidence of identity is required. This must be a valid passport or a
Permanent Resident Card (PRC)
bearing a photograph, a number and a signature. The evidence of identity must
show the full name of the applicant in English lettering, including expiry date and the date of birth. CHECK the
appropriate identification document which you will be using as identification and enter the number in the space
available. Please remember that you must bring this same document of identity on the test day.
: If you have sent your passport to your agent/attorney or Immigration Office, you must retrieve it in order to sit
for the IELTS test, and send it back to them after the test is finished. If you do not have your passport or a Canadian
Permanent Resident Card, do NOT apply for the IELTS test until you have your document with you for test day.
11 Country of Origin
: Enter the country of origin code in the appropriate boxes (codes can be found on page (ii) of the
Application Form). PRINT your country of origin in the space provided.
12 First Language
: Enter your first language code in the appropriate boxes (codes can be found on page (iii) of the
Application Form). PRINT your first language in the space provided.
13 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 on page (iv) of the Application Form).
14 Why are you taking this test
? Select the correct number code and enter in the appropriate box (codes can be found
15 Which country are you applying/intending to go to
? Respond to this question as appropriate.
16 Which IELTS module are you taking
? Check as appropriate.
module assesses 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 the Academic module. Academic module is for professional registration as well.
The General Training
module is 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 immigration purposes for some countries. It may also be suitable for candidates who are going
to English-speaking countries to complete their secondary education, or to undertake work experience or training
17 Which IELTS test are you taking?
CBIELTS (computer-based) is currently not offered at this Test Centre. All parts of
the test will be paper-based. Therefore, please check Pen and Paper Test ONLY.
18 Have you taken IELTS before?
Check as appropriate. The restriction on re-taking IELTS within 90 days has been
removed since May 2006. Candidates will be able to repeat the test whenever they like.
19 Most recent IELTS test details:
This should be completed only if you have taken the IELTS test within the last two
years. Otherwise, leave this section blank.
20 Where are you currently studying English?
Answer if applicable.
21 What level of education have you completed?
Check as appropriate.
22 How many years have you been studying English?
Circle as appropriate.
23 Do you have any special needs due to ill health/medical conditions?
Descriptions of accommodation for special
needs can be found in the IELTS Handbook and on our website. Please note that 3 months notice is required for these
needs to be accommodated and supporting medical evident is required.
24 Name of academic institutions (college/university) / government agencies (consulates) / professional bodies
(for professional registration) / employer you would like results sent to:
PRINT the name and the complete
address(es) you would like your test results sent to. Please note that you may request for up to 5 institutions within one month of your test in North America at no charge – for additional institutions after one month of your test, please
include a processing fee of $15.00 per copy. Note that a $30.00 international courier fee is mandatory for all overseas
destinations. If you have a file, case or student number, please include this as well.
photographs are acceptable and must be attached to the IELTS Application Form. The passport
photographs should be a ‘head and shoulders’ shot, taken within the last six months, be on white/beige
background (NOT blue or red), and stamped and dated on the back by the photo shop. The second identical
photograph (stamped and dated on the back) should be paper-clipped to the Application Form. Photocopied,
digitally enhanced, scanned or photo-booth images are not
Sign and date the Application Form.
(We advise you to keep a copy of your Application Form for
It is vitally IMPORTANT that you read and understand the content of the Application
Form – in particular ‘Your Rights’, ‘Declaration’, ‘Disclaimer’, ‘Rules and
Regulations’ and ‘Advice and Information’ before you sign your Application Form.
– complete the “Payment Authorization Form” and send with your Application Form.
Money Order or Certified Cheque
– payable to “Conestoga College”. Attach Money Order or Certified Cheque
to the Payment Authorization Form, indicating what you are paying for and send with your Application Form.
Photocopy and include the page(s) of your original, valid passport or Permanent Resident Card (PRC)
showing your photograph, passport number, birth date and signature. Please remember that you must bring
this same document of identity on the test day.
Where to send the completed IELTS Application Form together with payment:
If you have questions or need additional information, contact us at:
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