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IELTS-Request-Refund-Test-Date-Transfer-Form PDF

1. Phạm Minh Triết is requesting a test date transfer for the IELTS exam from August 22, 2020 to September 26, 2020 at the IDP Da Nang test center in Vietnam. 2. The original test date was postponed due to the Covid-19 pandemic and IDP's request to change the date. 3. Phạm Minh Triết signed the request form on August 12, 2020 for the test center to process.

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Minh Triết
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3K views

IELTS-Request-Refund-Test-Date-Transfer-Form PDF

1. Phạm Minh Triết is requesting a test date transfer for the IELTS exam from August 22, 2020 to September 26, 2020 at the IDP Da Nang test center in Vietnam. 2. The original test date was postponed due to the Covid-19 pandemic and IDP's request to change the date. 3. Phạm Minh Triết signed the request form on August 12, 2020 for the test center to process.

Uploaded by

Minh Triết
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PR O UD C O - OW NER OF IELT S

Request for Refund or Test Date Transfer Form


PERSONAL DETAILS
TITLE: Mr

GIVEN NAMES: PHẠM MINH TRIẾT

FAMILY NAME: NGUYỄN

ADDRESS: 67 NGUYEN HUY CHUONG, TAM KY CITY, QUANG NAM PROVINCE

NATIONAL ID/ PASSPORT No: 206324823


TELEPHONE: 0702499106 EMAIL: [email protected]

CHANGE REQUESTED:
Request is for (tick one box): □ REFUND □ TEST DATE TRANSFER

CENTRE NAME / NUMBER: IDP DA NANG / VN501


TEST DATE REGISTERED FOR: 22 / 8 / 2020

MODULE REGISTERED FOR: □ ACADEMIC □ GENERAL TRAINING

Please select the test that you registered for:

□ IELTS (Paper Based) □ Computer-delivered IELTS □ IELTS for UKVI (Paper Based)
□ IELTS for UKVI (Academic) (Computer-delivered) □ IELTS Life Skills
PREFERRED NEW TEST DATE: 26 / 9 / 2020

PREFERRED NEW MODULE: □ ACADEMIC □ GENERAL TRAINING

Please select the test that you wish to transfer to:

□ IELTS (Paper Based) □ Computer-delivered IELTS □ IELTS for UKVI (Paper Based)
□ IELTS for UKVI (Academic) (Computer-delivered) □ IELTS Life Skills
TEST TAKER STATEMENT
Please detail your reasons for applying for a refund or a test date transfer.

In case of medical reasons, this form must be accompanied by an original medical certificate. For other reasons, please attach relevant
documentation/evidence (police report, military service notice, death notice). Attach an extra sheet if there is insufficient space.

Kì thi bị IDP hoãn do ảnh hưởng của dịch Covid-19 và IDP yêu cầu
đổi ngày thi

TEST TAKER SIGNATURE: DATE: 12 / 8 / 2020

RECEIVED BY: DATE: / /

TEST CENTRE USE ONLY:

Request (please select): □ APPROVED □ NOT APPROVED


AUTHORISED BY:
DATE: / /
(IELTS ADMINISTRATOR)

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