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DELF DALF Exam Session June 2019 Registrations 29 April- 18 May 2019

REGISTRATION FORM PLEASE: USE CAPITALS AND GIVE YOUR NAME EXACTLY AS YOU WANT IT ON YOUR CERTIFICATE

Candidate’s code (in case you have already attended DELF DALF exam):

0 9 1 - 0

First name

Surname or initials

Sex M F Date of birth (DD/MM/YYYY)

City/Town of birth

Address

/ / Nationality

Country of birth

Postal code City

Telephone e-mail

Exam Day AF Student Fee Non-AF Student Fee

DELF A1 Monday 10 June 2019 □ Rs.4,012/- □ Rs. 8,024/-

DELF A2 Tuesday 11 June 2019 □ Rs. 4,012 /- □ Rs. 8,024 /-

DELF B1 Wednesday 12 June 2019 □ Rs.5,310 /- □ Rs.9,440/-

DELF B2 Thursday 13 June 2019 □ Rs.5,310/- □ Rs.9,440 /-

DALF C1 Friday 14 June 2019

□ Rs.6,490/- □ Rs.10,856 /- Lettres et sciences humaines / Sciences

DALF C2 Saturday 15 June 2019

□ Rs.6,490 /- □ Rs.10,856 /-

Lettres et sciences humaines / Sciences

Only if you are a student of AFM: Level and time of your class:

Name of the teacher:

IMPORTANT – FOR ALL CANDIDATES: “I hereby declare that all the particulars furnished above are true and correct to the best of my knowledge and belief.”

Date and signature of the candidate:

Alliance française of Madras | 24 College Road - Nungambakkam - Chennai | +91 44 2827 9803 / 2827 1477 | www.af-madras.org

Registration – Choose the level (please note that you cannot register for an exam you have already succeeded)

Personal data (give your name exactly as you want it on your certificate)

Photo

FOR ADMINISTRATION ONLY

Receipt number:

Date: