ielts payment by debit/credit card - guildford · ielts payment by debit/credit card ... ielts exam...

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IELTS PAYMENT BY DEBIT/CREDIT CARD "I understand that my test fees are only refundable or transferable up to 5 weeks before my test date (minus an administration fee of £30). Less than 5 weeks before my test I am liable to lose my full test fee unless I can provide adequate medical proof to support my application to cancel or postpone." "I understand that my course fees are not transferable or refundable if my application is accepted. I note that IELTS courses are not eligible for a student visa." Signature: Date: NAME OF APPLICANT/ CANDIDATE: CARD NUMBER: EXPIRY DATE: START DATE if on card: CARD TYPE, e.g. Visa, Visa debit, MasterCard (NB: NO Amex taken) AMOUNT PAYING: Please tick IELTS Official Practice Materials 2 (with DVD): £15 ☐ IELTS Evening Preparation Course: 2015 - £169 ☐ 2016 - £175 ☐ IELTS Exam: 2015 - £150 ☐ IELTS Exam 2016 - £155 ☐ IELTS One Day Workshop: 2015 - £69 ☐ 2016 - £78 ☐ IELTS Weekend Preparation Course: £435 ☐ SECURITY NUMBER: FINAL 3 DIGITS ON BACK OF CARD ISSUE NUMBER: SWITCH & SOLO If no issue number, start date CARDHOLDER NAME IF DIFFERENT TO APPLICANT: CARDHOLDER ADDRESS IF DIFFERENT TO APPLICANT: CARDHOLDER TEL: DATE DETAILS TAKEN: (For office use) TAKEN BY (NAME): (For office use)

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Page 1: IELTS PAYMENT BY DEBIT/CREDIT CARD - Guildford · IELTS PAYMENT BY DEBIT/CREDIT CARD ... IELTS Exam : 2015 - £15 0 ☐ IELTS Exam 2016 - £155 ☐ ... IELTS Weekend Preparation Course:

IELTS PAYMENT BY DEBIT/CREDIT CARD

"I understand that my test fees are only refundable or transferable up to 5 weeks before my test date (minus an administration fee of £30). Less than 5 weeks before my test I am liable to lose my full test fee unless I can provide adequate medical proof to support my application to cancel or postpone." "I understand that my course fees are not transferable or refundable if my application is accepted. I note that IELTS courses are not eligible for a student visa." Signature: Date:

NAME OF APPLICANT/ CANDIDATE:

CARD NUMBER:

EXPIRY DATE:

START DATE if on card:

CARD TYPE, e.g. Visa, Visa debit, MasterCard (NB: NO Amex taken)

AMOUNT PAYING: Please tick

IELTS Official Practice Materials 2 (with DVD): £15 ☐

IELTS Evening Preparation Course: 2015 - £169 ☐

2016 - £175 ☐

IELTS Exam: 2015 - £150 ☐ IELTS Exam 2016 - £155 ☐

IELTS One Day Workshop: 2015 - £69 ☐ 2016 - £78 ☐

IELTS Weekend Preparation Course: £435 ☐

SECURITY NUMBER: FINAL 3 DIGITS ON BACK OF CARD

ISSUE NUMBER: SWITCH & SOLO If no issue number, start date

CARDHOLDER NAME IF DIFFERENT TO APPLICANT:

CARDHOLDER ADDRESS IF DIFFERENT TO APPLICANT:

CARDHOLDER TEL:

DATE DETAILS TAKEN: (For office use)

TAKEN BY (NAME): (For office use)

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