04 Theory Entry Form 12 Spring Final

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Trinity College London

Teacher / School Name: PO Box: City: Emirate: Email:

Theory Examinations Sat 12 May


Contact Name: Residence Phone: Office Phone: Contact Fax:

Is the Teacher___ or School___ Name above required on the certificate? YES___ NO___ (please tick) Please number each page if submitting more than one sheet of entries: Page

The following are entries for UAE Theory Examinations for the Saturday, 12 May 2012 session:
Male / Female

Grade

Candidate Name (as required on certificate) < Please

spell names correctly >

Date of Birth

Fee (AED)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

/ / / / / / / / / / / / / / /
Delivery Method for Appointment Slips, Exam Reports and Certificates: Three Choices

/ / / / / / / / / / / / / / /
TIC
Fee (AED)

Send all of the above by Courier Service (appt slips, exam reports, certificates) - Add 120 AED per teacher Appointment slips, exam reports and certificates for pick-up at Trinity Knowledge Village Bldg 13 Off G-23 Send by Post (replacements for documents lost in the post are not available)

120 Free Free

NO refunds are given to candidates who are absent (see Syllabus for Absence through sickness). Total : Add up the total fees (fees and grades are listed overleaf) including delivery service:

Pay the fees into this Bank Account: Tyler Smith Union National Bank Account Number: 6102302905 Swift Code: unbeaeaa IBAN: 900450000006102302905 Any branch in the UAE..

Deliver and/or fax this form and the bank paying-in slip to the following address no later than 22 Feb 2012: Mr. Tyler Smith Orpheus-TG PO Box 502191 Tel: Off. 04 391 1949 Mob. 050 550 3576 Fax: 04 366 4581 Email: tylersmith@trinitycollege.co.uk

Please sign the declaration : I agree to abide by the Trinity Guildhall Examinations regulations as published by Trinity College London.

Signature: _________________________________________

Date: ______________

Trinity College London


Grades and Fees:
Grade #

Theory Examinations Sat 12 May 2012 Fees

Grade (NEW Syllabus only) Grade One Grade Two Grade Three Grade Four Grade Five Grade Six Grade Seven Grade Eight

Fee (AED) 167 190 219 226 236 271 308 327

01 02 03 04 05 06 07 08

Important Notes:
1 If you are submitting more than fifteen candidates, please use photocopies of this form and number pages. 2 No late entries can be accepted for Theory examinations. 3 All entries and fees must arrive by 22 February 2012. 4 NO refunds are given to candidates who are absent (see Syllabus for Absence through sickness). 5 Theory examinations will be held on Saturday, 12 May 2012. 6 Please ensure that your students are free to attend the examination before accepting their entries. 7 Candidates should arrive 30 minutes before exam. 8 Please check spelling of candidate names. 9 Items lost in the post may not be replaceable (consider courier or pick-up option). 10 Please contact me directly for Written Diploma Exams. 11 Exams will be held in Dubai and Abu Dhabi 12 Please sign and date form on reverse side.

First, fax this form together with the Union National Bank Payment slip to: 04 366 4581 Then, post this form together with the Union National Bank payment slip to:

Mr.Tyler Smith, Orpheus-TG, Knowledge Village, PO Box 502191, Dubai, UAE OR Bring the form and the correct amount in cash to the TG Centre, Building 13, Office G-23, Knowledge Village / Saturday-Tuesday, 12-5pm

Closing date for Theory entries

22 February 2012

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