Individual Member Application Form

Please complete and sign Forms A and B below and send them to your local representative. If you return these forms via email your signature will be assumed to have been given in agreement to the conditions as stated.

Form A

Name of Teacher*

Full Address

Postcode*

Street and number*

Town / City*

Province / State / Department*

Country*

Telephone

Country Code*

Area Code*

Number*

Country Code*

Area Code*

Phone*

E-mail Address*

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Form B

In applying to become an Anglia Member, I agree to:

Identify a single named point of accountability (Contact Name, above) for the quality assurance and management of the qualifications*

Promote the examinations among my students*

Collect the entry fees from individuals and submit the payments due to Anglia ESOL Examinations with the relevant entry data*

Follow the procedures laid down by Anglia ESOL Examinations*

In applying to become an Anglia Member, I agree not to:

Reproduce in any way whether in whole or in part the examination papers, audio or other materials prepared by Anglia ESOL Examinations*

Promote any examinations other than these ones under the terms of this agreement*

Individual Member Application Form

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Central Exams Office

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