2021 Cambridge Assessment English Provisional Registration Form
Please complete the following form to start the booking process. Please note, your registration with Cambridge Assessment English will only be complete once CBE Languages has received full payment for the exam.

PAYMENTS should be made by electronic transfer to

CBE Languages
IBAN: NL85RABO0311856144
Description: Your name, the exam you are paying for, the date of the exam

Once payment has been made, cancellation of your registration up to four weeks before the exam will incur a cancellation fee. The cancellation fee is Euro 85,-. Cancellations can be made up to four weeks prior to the exam date.

To avoid incurring any late adjustment fees, please fill in the form as carefully and as accurately as possible.

Once payment has been made, and the closing date has passed, it is no longer possible for you to receive a monetary refund upon cancellation. If you are unable to take the exam due to illness or other significant reason, you will need to submit a medical certificate from a registered medical practitioner and/or contact our exams manager with details. Cambridge Assessment English will evaluate the circumstances and if they are accepted, you will be issued a credit note. This credit note entitles you to take the same exam at a date in the future when you have recovered from your illness.
Please note, in cases where candidates do not have a medical certificate or valid reason for absence, no credit refund will be issued.

Your completion of this form indicates to CBE Languages that you have read, understood and accepted the following terms.
Email address *
Which exam are you registering for? *
If you wish to register for an A2 KET, B2 PET or Delta Module 1 exam, please send an email to cambridge@cbelanguages.nl
What is your full first name? Write it as it appears on your passport and driving license. Write your first name and middle names e.g. Johan Eric *
What is your surname / family name? Please write it in full (no abbreviations) E.g. van der Hoeven *
Please state your gender *
It is preferable that the option you select matches your identification, but we are sensitive to gender matters, so if there are any inconsistencies, please contact our director of studies, Emma. We will deal with these situations with the highest level of confidentiality.
What is your birthdate? Write day - month - year e.g. 27 - Jan - 1981 *
NOTE! Please write the month as a word NOT a number
Which email address would you prefer us to submit to Cambridge Assessment English? Note: Your confirmation of Entry and Results password will be sent to the email address you provide. *
What is your telephone number? *
Do you have any physical or learning difficulties that would require modified materials or extra time during the exam? If so - please send official proof of your condition to Emma at cambridge@cbelanguages.nl at least 6 weeks before the exam date. *
All documentation will be treated confidentially.
If you answered yes to the question above, please provide more details:
Are you interested in taking an exam preparation course? *
Have you read the terms regarding payments and refunds and do you accept them? If you select "No", we will not be able to process your registration. *
In order to book your place on the exam day, CBE Languages must share your personal data with Cambridge Assessment English, an organisation registered outside the Netherlands. Do you allow CBE Languages to store your personal data for a maximum of 5 years and allow us to provide Cambridge Assessment English with your contact details in order to register you for the exam? We will ONLY use your data for the purposes of fulfilling our obligations to you as an exam service provider. Refusal to allow us to store and process your data will result in us deleting your registration. You will therefore not be registered for the exam. *
Have you taken down our banking details? CBE Languages Rabobank IBAN: NL85RABO0311856144 BIC: RABONL2U *
Which amount are you paying? *
Please note, you will be issued a confirmation of entry (COE) once the timetabling has been done for the exam. This will only be done after the registration closing date and could take a number of weeks to be finalised. The COE will include the location address of the exam and the exact times of each exam. With the exception of this information, do you have all of the information you require? *
What information would you still like CBE Languages to provide you with?
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