New 2nd Copy Form (1)

I, THE UNDERSIGHNED HEREBY DECLARE THAT I HAVE TAKEN THE IELTS EXAM AT THE BRITISH COUNCIL IN RAMAT GAN ISRAEL. I DID NOT RECIVE THE RESULTS AND I HEREBY REQUEST TO HAVE THEM SENT AGAIN TO THE FOLLOWING ADDRESS. I UNDERSTAND THAT I WILL NOT BE ABLE TO RECEIVE ANY FURTHER COPIES.

CANDIDATE NAME:_________________________________________________________ CANDIDATE NO.:____________________________________________________________ ORIGINAL TEST DATE:______________________________________________________ REQUIRED ADDRESS: 1._________________________________________________________________________

CANDIDATE SIGNATURE:____________________________________________________

THANK YOU, EXAMS OFFICE THE BRITISH COUNCIL 12 HAHILAZON ST. RAMAT GAN 5136 ISRAEL FAX NO. +972(0)3 6113640 TEL NO. +972(0)3 6113600 www.britishcouncil.org/israel