PDF《Entry form: China》

1 至4部份. 当您填妥表格后,请保留印有指引的一页以备咨询之用.将填妥 表格的其余部份及考试费用寄给您当地的代表处. |? ?| 1a Applicant information all Applicants 申请人资料 所有申请人 Applicant Number 申请人编号 Title 称谓 Name 姓名 Identity card number 身份证号码 Degrees/Diplomas 学位/文凭 Address 地址 Postal code 邮政编码 Country 国家 Home telephone 住宅电话 Work telephone 办公室电话 Mobile phone 手机号码 Fax 传真 Email 电邮 1b Certi?cate information optional 证书资料 如适用 Name of presenter 推荐人姓名 Preferred exam date 考试日期选择 |? ?| 1c Place of exam all Applicants 考试地点 所有申请人

2 Practical exam date preferences optional 考生欲报考演奏考试的日期 如适用 |?? ??| please underline family name (surname) 在姓氏下划上横线 Please note that completing this section does not guarantee that your choice will be met 请注意填写本部份并不能保证满足考生的选择?? My address/ contact details have changed since my last entry 我的地址/联系 方式与上次申请 时已不同 Music school 音乐学校 Music teacher 音乐教师 Parent 家长 Self-entry 自我申请 tick if applicable 如适用请打勾 you may tick more than one 您可以勾?一 个以上的选择 Practical/Theory insert P or T 演奏/乐理 填写 P 或Toptional 可选填 for example Dr, Mr, Mrs, Mdme, Miss, Ms 例如s博士,先生,夫人,太太,小姐,女士

3 Candidate information all Applicants 考生资料 所有申请人 Candidate'

s name as to be shown on certi?cate. Please underline family name (surname) 考生要求在证书上出示的名字. 在姓氏下划上横线. Total fees enclosed 合计考试费金额 | | | | | | Subject code 科目代码 Grade 级别 Date of birth 出生日期 Speci?c needs or requests 特别安排或要求 ID card number 身份证号码 Subject code 科目代码 Grade 级别 Date of birth 出生日期 Speci?c needs or requests 特别安排或要求 ID card number 身份证号码 Subject code 科目代码 Grade 级别 Date of birth 出生日期 Speci?c needs or requests 特别安排或要求 ID card number 身份证号码 Interpreter/translation required 传译员/译本需要 Interpreter/translation required 传译员/译本需要 Interpreter/translation required 传译员/译本需要

1 2

3 4 Fees all Applicants 收费表 所有申请人 PA 表演评估 PT 预备级测试 Grade

1 第一级 Grade

2 第二级 Grade

3 第三级 Grade

4 第四级 Grade

5 第五级 Grade

6 第六级 Grade

7 第七级 Grade

8 第八级 ARSM ARSM no.of cands. 考生人数 fee per candidate 每个考生收费 total per grade 每级总考试费 Attach passport photo here 请在此贴上护照 相片 Attach passport photo here 请在此贴上护照 相片 Attach passport photo here 请在此贴上护照 相片 Grades 6C8 Practical and ARSM: Tick the Prerequisite box to con?rm the candidate holds the correct prerequisite. 第6C8 级演奏及 ARSMs勾选先决条件栏确认考生满足 报名资格 Prerequisite 先决条件 Prerequisite 先决条件 Prerequisite 先决条件

5 Declaration all Applicants 考生资料 所有申请人 This form must be signed and dated by the applicant (who must be

18 or over) as the person who enters into a contract with ABRSM upon the terms and conditions set out in ABRSM'

s Exam Regulations. It should not be signed by the candidate except if the candidate is

18 or over and wishes to enter the exam him or herself. 作为依照ABRSM的考试规则所述的条款和条件与ABRSM签订合同 的当事人,申请人(须年满18岁)必须在此表格上签名并注明日期. 除非考生年满18岁并且是本人参加考试,否则此表格不应由考生 签名. ABRSM and ABRSM Publishing will use the personal information that you provide to administer your exam booking process and in accordance with applicable data protection laws and our Privacy Policy - Please visit www.abrsm.org/privacypolicy. ABRSM 和ABRSM出版社将根据适用的个人信息保护法和公司制定 的隐私权政策使用您的个人数据 (请参阅 abrsm.org/privacypolicy). Please tick here and sign below to con?rm your entry of the candidate(s) for the exam(s) upon the terms and conditions set out in ABRSM'