Application

Family name (surname) First name (given) Middle name

Date of birth

Gender

Street

Street 2

City State

Zip

Phone

Other phone

Other phone/fax

E-mail

Other e-mail

Emergency contact name

Emergency contact phone

May we use this contact for non-emergencies?

These arrangements available to candidates who have a disability or special requirement, and are entitled to support for exams.

Please indicate if you require access arrangements.

UCAS Number

Name on UCAS Application (must match the name on this registration form)

University Name(s)

University Course(s)

University Course Code(s)

University Initial Semester Start Date

Testing times are still being finalized. You will recieve an email whent he times are confirmed. Please select your test.

Wednesday, October 18, 2023

*Paper-based Test

I certify that the information on this application is true. In addition, I have read, understood and agree to AEI’s policies

How did you find out about the Atlanta English Institute's Test Centre?