Northstaruk Enrolment Form (2009-2010)

NorthStarWorldwide– Exam entry form

Please complete a separate form for each candidate

Please indicate when you wish the candidate named below to sit exams with NorthStarWorldwide? / June 2018November 2018 *

*Please select if the candidate is currently enrolled on NorthStarWorldwide

*Please select if the candidate has previously taken exams at the NSW exam centre.

Parent/Carer contact information

Family Name / First Name
Relationship with candidate / Title
Mailing address / Postcode
Full Phone No / Mobile Phone No
Email address of parent/carer

Candidate Information

Family Name / First Name
Please note that these are the names that will appear on the final certificate issued by the exam board
Date of Birth / Gender FemaleMale
If the candidate previously sat GCSE/IGCSE examinations, and was allocated either a UCI or a ULN, please provide these numbers below. If the candidate has never been provided with either number then please leave these boxes blank.
UCI / ULN
Photo Identification
It is necessary for candidates to provide photo identification, e.g. a passport or citizencard,prior to sitting exams with NorthStarWorldwide. Failure to provide photo ID is likely to result in a candidate not being permitted to sit the exam. The ID will be copied and retained securely by the centre for use in future exam sessions.
*Please select if you want the ID destroyed once the exam results are published.

Exam details

It is important that you provide correct information in this section. Failure to do so could result in the candidate being given the wrong exam papers to sit.

Note – Please ignore the first line

Subject / Papers / Syllabus Code / IGCSE, GCSE,
O level or
A level / Exam Board
Maths SAMPLE / 1, 2, 4 / 0865 / IGCSE / CiE

Access Arrangements

Does the candidate have diagnosed learning difficulties or medical needs that require access arrangements such as additional time, rest breaks etc. in order to sit exams or that require other special arrangements? / NOYES*
If you answered YES to the previous question please provide further information. You should also ensure that you have read the information on the Access Arrangements page of our web site. We will contact you to discuss your requirements, once you have submitted this form. There are additional fees relating to access arrangements – refer to our web site for further details. (Feel free to attach additional sheets). Ensure that your name and the name of the candidate is placed at the top of each additional sheet that you submit.
Please note that we are not able to provide a full range of access arrangements. In addition, as a small exam centre, places do fill up quickly. Submitting this form does not commit NSWEA to accepting your application or to providing exam facilities for the candidate named above.

Fees and Payment Information:

Current exam and related fees can be found on our web site –

Please tell us what method of payment you wish to use (select ONE option from the drop down list, below)

I wish to pay by: / Bank TransferDebit/Credit Card*
Once you have submitted your Exam Entry Form, you will receive an invoice by email, clearly showing your payment method and the sum of money that is due.

Declaration

I wish to enter (please insert candidate’s name) to sit the exams listed above at the NorthStarWorldwide exam centre, for the exam sitting selected at the top of this form.

I undertake to pay all fees due by the dates given on the invoice that I will receive after submitting this form.

If you are completing this form electronically and submitting it online, please select this box as a form of electronic signature. / *
If you are submitting this form by fax or post please sign below
signed: / Date
Please return the completed form to:
Exam Entries, NorthStarWorldwide, 4 Lea Road, Dronfield, S18 1SB, UK, Tel: +44 (0) 1246 410122