/ Results Review request form

Section 1: Centre details

Centre name:
Bla Bla Company (Sócrates Comunicación s.l.l) / Centre no:
54548
Address: C/ Jardín de Sócrates nº 4, local 2, 18002 Granada
(see note 1)
Tel no: 958 – 53 61 16 / Fax no:
Email address:
(see note 1)
Contact hours: 09:00 à 14:00 y 17:00 à 22:00 h.
(see note 2)
Trinity representative at the centre: Salvador Cantal
(see note 3)

Section 2: Exam session details

Examination type: (please circle) / GESE (Graded Examinations in Spoken English) / ISE (Integrated Skills in English) / SEW (Spoken English for Work) / ESOL Skills for Life
Total number of candidates entered for session:
Highest and lowest grades entered:
Date/s of examination session: AM PM Granada / /
(see note 4)
Date results received: / /
(see note 5)
Examiner’s name:
(Speaking & listening exam only)
Other examiners present at this session:
(Speaking & listening exam only)
Section 3: Results review details (see notes 6, 7 & 8)
Level / Candidate name(s) / Candidate number(s)
1) ISE IISE IIISE III
2) ISE IISE IIISE III
3) ISE IISE IIISE III
4) ISE IISE IIISE III
5) ISE IISE IIISE III / 1)
2)
3)
4)
5) / 1)
2)
3)
4)
5)
Exam component to be investigated:
(please circle) / Speaking and Listening exam(GESE/ISE/SEW/Skills for Life) / Written exam
(Skills for Life/ ISE) / Reading exam
(Skills for Life/ ISE) / ISE Portfolio
(ISE only)
Please state the reason(s) for the Results review below.
(Please attach additional sheets if necessary.)
Section 4: Accompanying documents (see notes 9)
If you are sending original documentation please confirm below (please tick):
·  the required supporting documents are enclosed
·  proof of payment of the fee
· 

Signed by Trinity Centre representative: Salvador Cantal Date: Granada / /2017

Trinity College London, Blue Fin Building, 110 Southwark Street, London SE1 OTA, UK
Tel +44 (0)20 3752 4700. Website www.trinitycollege.com