Registration Form DELF B2 Junior Exam PhilaFLAM
this is to register for the exam day on June 8th. Merci !
Candidate’s Code (if you have previously taken the DELF Junior) : _ _ _ _ _ _ - _ _ _ _
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Candidate Information
(as it appears on your passport, ID Card or birth certificate)
Title
First Name:
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Last Name:
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Date of Birth:
MM
/
DD
/
YYYY
Place of Birth - City:
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State: (write out)
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Country of Birth:
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Nationality(ies):
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Native tongue:
Present Address:
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City:
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State:
Zip Code:
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Home Phone:
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Cell Phone:
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Your Email Address:
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Parent/Guardian’s Name:
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Parent/Guardian’s Cell Phone:
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Parent/Guardian’s Address: if different
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Parent/Guardian’s Email Address:
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Student's status:
Your grade if enrolled in school - (type just 10 if in 10th grade)
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Name and address of the school
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Reason(s) for taking the exam, check all that apply?
Your registration will be confirmed once the payment of your exam fee is processed. You will receive an email shortly with all the information once you fill this form.
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Would you like to receive your diploma:
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You will receive a notification with time, room numbers, and important information concerning your exam after the registration deadline has passed. Merci et à bientôt!
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