Center Name: British Council

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1 GCE O-Level OCTOBER / NOVEMBER 2014 CAMBRIDGE INTERNATIONAL EXAMINATION Staple your photo GENERAL CERTIFICATE OF EDUCATION ORDINARY LEVEL here. Write name at Candidate No: (For Office use only) the back of photo Center No. MY 001 Center Name: Previous Center No. Previous Center No. Previous Candidate No. You must fill up the boxes above with Previous Center No. and Previous Candidate No. if you wish to sit for retake component. NORMAL REGISTRATION LATE REGISTRATION FIRST-TIME REGISTRATION: 18 JULY AUGUST AUGUST SEPTEMBER 2014 RETAKE REGISTRATION : 18 JULY SEPTEMBER SEPTEMBER SEPTEMBER 2014 NAME: (WRITE IN CAPITAL LETTER) DATE OF BIRTH: (DD/MM/YYYY) GENDER: MALE FEMALE ID/PASSPORT NO: PH NO: GUARDIAN PH NO (MANDATORY FOR UNDER 18) (MANDATORY): We are sending notification and/or necessary information to your primary . Please provide readable and clear to avoid any inconvenience. We advise you to regularly check your for update and information. ADDRESS: A copy of statement of confirmation will be sent to the address given above. We are not sending statement of confirmation abroad. Alternatively, you can request for soft copy to your . Registration Checklist: Completed application form. Copy of IC/Passport/ Copy of official supporting letter from the embassy for visa renewal (if any). One recent colour passport size photo. Copy of previous exam certificate or result if you wish to retake or mark carried forward. Attach a copy of medical report for access arrangement request if applicable.

2 DECLARATION: I understand and agree, 1. That my personal data and information provided into this form are accurate to the best of my knowledge, adequate and relevant for the purpose of this registration, 2. that I must and have studied each component specification and requirement which has been made available in the exam board webpage at 3. That I have referred to, and noted of the timetable and exam venue advices published in examination board or the webpage for which, the shall not be held liable in the event official notification, statement, information, update and/or changes fail to reach me in time. 4. That I shall not make CIE and/or Edexcel entry at any other center than the within same examination session, and/or component that may result in timetable clash for which the will not facilitate such clashing. 5. That the date(s) and/or time(s) of each examination, at no circumstances shall be deferred, rescheduled, postponed, cancelled, and/or transferred. 6. That the refund is only claimable on the ground of none other than medical which must be accompanied by supporting official letter under the signature and stamp of authorized conventional medical practitioner, and is subject to the center fee policy. By signing below, I confirm that I have read and agree to abide by all of the provisions and declarations in this application. Applicant s signature

3 Circle syllabus unit which you wish to take. Do not forget to circle R indicated next to component column if you are intending to retake the unit. CODE SYLLABUS TITLE UNIT COMPONENT RETAKE FEE 1123 English Language as 0500, 0511 or Literature in English as Religious Studies (Bible) as Hinduism as 8058, or Islamic Religion & Culture as 0493, 2058, 8053, or Islamiyat as 0493, 2056, 8053, or History (World Affairs, ) as Geography as Y 12: Writing 22: Reading Z 13: Paper 13 Z 13: Luke & Acts (Short Asnwer) 23: Luke & Acts (Essay) 01: Paper 1 Z 13: Paper 13 AY 12: Paper 12 22: Paper 22 AY 12: Paper 12 Z 13: Geographical Themes 23: Investigation & Skills 2281 Economics as Z 3025 German B A 01: Translation & Composition 13: Multiple Choice 23: Structure Questions 02: Reading Comprehension 3035 Spanish B AY 12: Translation & Composition 22: Reading Comprehension as 0502, or Setswana 01: Language 4024 Math Syllabus D as 0580, 0581 or Add Maths as Statistics Z 13: Paper 13 23: Paper Environmental Management as Physics as 0625, 0652, 0653, 0654, or Chemistry as 0620, 0652, 0653, 0654 or Biology as 0610, 0653, 0654, 5096, or : Literature Y 12: Paper 12 22: Paper 22 AZ 13: Paper 13 23: Paper 23 BY BY BY 12: Paper 12 22: Paper22 22: Theory 22 42: Alternative to Practical 22: Theory 22 42: Alternative to Practical 22: Theory 22 62: Alternative to Practical

4 5129 Combined Science as 0610, 0625,0652, 0653, 0654, or Art as Computer Studies as Travel & Tourism as Commerce as Commercial Studies as Principles of Accounts as 0452 or Business Studies as AY 22: Theory 22 A 01: Still Life 02: Observation AA 01: Still Life AC 02:Observation 04:Composition in Colour RM 1420 AD 02: Observation B 01: Still Life 02: Observation R G 01: Still Life P 02: Observation X 01: Still Life 02: Observation Z 01: Still Life BZ 13: Paper 13 82: Project Mark Carried Forward CZ 13: Paper 13 33: Alternative to Coursework AZ 13: Paper 13 23: Alternative to Coursework CZ 13: Paper 13 83: Coursework Mark Carried Forward Y 22: Written AY Y Y 12: Elements of Commerce 22: Arithmetic 22: Structured 12: Short Answer 22: Case Study

5 CONSENT FOR EXAMINATION I, the undersigned, hereby agree and authorize the to disclose my personal data, such as my name, date of birth, gender, ID/Passport No., and information pertaining to this application to Cambridge International Examination ( CIE ) for purpose of providing and registering IGCSE/GCE O-Level/AS/A-Level examinations. I understand that any personal data provided by the to CIE shall also be subject to CIE s privacy policy. Signature of Applicant Date Late Registration penalty fee: 1 st stage : RM per candidate (non-refundable) + no. of syllabus x RM per syllabus (non-refundable) Total number of subjects or syllabus x RM Total number of subjects or syllabus x RM Total number of subjects or syllabus x RM Total amount (payable to ) For official use only Date of Payment: Receipt Number: Amount Paid: Date: Registered By: Payment options: transaction shall be made payable to BRITISH COUNCIL Cash Credit Card Cheque Bank Draft Bank Transfer Kuala Lumpur Penang Kota Kinabalu Bank Deposit Kuching

6 Kuala Lumpur & Penang Bank Details Bank : Citibank Bank Swift Code : CITIMYKL Account Number : Cash deposit must be made through the Citibank counter and via Cash Deposit Machine. If you wish to pay by cheque deposit, you may drop the cheque into the corporate box at Citibank. Sabah Bank Details: Bank : HSBC Bank Swift Code : HBMB MYKL Bank Account Number : Terms of fee and payment: 1. Payment can be made to the either by cash, cheque, credit card, bank draft, or bank transfer. 2. Payment made to the respective office is subject to Bank s transaction terms and conditions. 3. Registration will be processed upon receipt and validation of the copy of the remittance slip which may be by hand/courier together with the application form. Completed application form can be submitted by hand/courier to either of the office as below: Ground Floor, West Block Wisma Selangor Dredging 142C Jalan Ampang Kuala Lumpur Tel. No.: Fax No.: kualalumpur.exams@britishcouncil.org.my Counter opening times: Mondays to Fridays Saturdays & Sundays Ground Floor 4 Jalan Api-Api Off Jalan Gaya Kota Kinabalu Sabah Tel. No.: Fax No.: sabah.exams@britishcouncil.org.my Opening times: Mondays to Fridays 9.00am to 7.00pm 10.00am to 4.00pm 9.00am to 12.00pm 2.00pm to 4.00pm Penang centre Wisma Great Eastern Suite 3A.1 & 3A.2 25 Light Street Penang Tel. No.: Fax No.: penang.exams@britishcouncil.org.my Opening times: Tuesdays to Sundays 9.00am to 5.45pm Room A15 & A16, Chung Hua Middle School No. 1 Jalan Pending, Kuching Sarawak T +60 (0) F +60 (0) sarawak.exams@britishcouncil.org.my Opening times: Mondays to Fridays am to 12.00pm 2.00pm to 4.00pm

**All fees are inclusive of GST PEARSON EDEXCEL INTERNATIONAL GCSE EXAMINATIONS (IGCSE)

**All fees are inclusive of GST PEARSON EDEXCEL INTERNATIONAL GCSE EXAMINATIONS (IGCSE) Centre Name MAY/JUNE 2016 PHOTO Affix your most recent passport size photo here (write your name at the back of the