2) Test city location * — Choose — Tashkent Nukus Andijan Bukhara Fergana Jizzak Karshi Namangan Navoi Samarkand Termez Urgench
3) Preferred date of test * — Choose — 06.07.2019 18.07.2019 20.07.2019 27.07.2019 01.08.2019 10.08.2019 17.08.2019 24.08.2019 07.09.2019 12.09.2019 14.09.2019 28.09.2019 10.10.2019 12.10.2019 19.10.2019 26.10.2019 02.11.2019 07.11.2019 16.11.2019 23.11.2019 30.11.2019 07.12.2019 12.12.2019 14.12.2019
3) Preferred date of test * — Choose — 06.07.2019 26.10.2019 07.12.2019 14.12.2019
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * — Choose — 06.07.2019 28.09.2019 14.12.2019
3) Preferred date of test * No date No date
3) Preferred date of test * — Choose — 10.08.2019 28.09.2019 07.12.2019
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * — Choose — 24.08.2019 26.10.2019 12.12.2019
3) Preferred date of test * — Choose — 26.10.2019
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
3) Preferred date of test * No date No date
13) Country of nationality * — Choose — Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Ascension Island Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canary Islands Cape Verde Cayman Islands Central African Republic Ceuta and Melilla Chad Channel Islands Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern and Antarctic Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Mariana Islands Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Namibia Nauru Nepal Netherlands New Caledonia and Dependencies New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena and Dependencies Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Islands Tonga Trinidad and Tobago Tristan Da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican (Holy See) Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S.A. Wallis and Futuna Yemen Zambia Zimbabwe Other
14) First language * — Choose — Afrikaans Akan Albanian Amharic Arabic Armenian Assamese Aymara Azeri Baluchi Bambara Basque Bemba Bengali Bihari Bosnian Breton Bulgarian Burmese Byelorussian Catalan Chinese Creole Croatian Czech Danish Dari Dutch Dzongkha Efik English Estonian Ewe Faeroese Farsi Fijian Filipino Finnish Flemish French Fulani Ga Galician Georgian German Gilbertese Greek Gujarati HaitianCreole Hausa Hebrew Hindi Hungarian Ibo/lgbo Icelandic Igala Indonesian Irish Italian Japanese Javanese Kannada Kashmiri Kazakh Khmer Korean Kurdish Lao Latvian Lithuanian Luba Luo Luxemburgish Macedonian Malagasy Malay Malayalam Malinka Maltese Maori Marathi Marshallese Masai Mende Mongolian Nepali Norwegian Oriya Palauan Pashto Polish Ponapean Portuguese Punjabi Pushtu Quechua Rajasthani Riff Romanian Romansch Russian Samoan ScottishGaelic Serbian Setswana Shona Sindhi Singhalese Slovak Slovene Somali Spanish Swahili Swazi Swedish Tagalog Tahitian Tamil Tatar Telugu Tetum Thai Tibetan Tigrinya Tongan Trukese Tulu Tupi/Guarani Turkish Uighur Ukrainian Ulithian Urdu Uzbek Vietnamese Welsh Wolof Xhosa Yao Yapese Yiddish Yoruba Zulu Other
15.1) Occupation (sector) * — Choose — Administrative Services Agriculture, Fishing, Forestry, Mining Arts and Entertainment Banking and Finance Catering and Leisure Construction Industries Craft and Design Education Health and Social Services Installation, Maintenance and Repair Services Law and Legal Services Manufacturing and Assembly Industries Personal Services Retail Trade Technical and Scientific Telecommunications and the Media Transport Utilities (gas, water etc.) Wholesale Trade Other
*Occupation (sector) – Other *
15.2) Occupation (level) * — Choose — Self-employed Employer/Partner Employee (Senior level) Employee (Middle or Junior level) Worker in the home Retired Student Other
*Occupation (level) – Other *
16) Why are you taking the test? * — Choose — For higher education extended course (three months or more) For higher education short course (three months or less) For other education purposes For registration as a doctor For immigration For employment For professional registration (NOT medical) For personal reasons For registration as a nurse (including CGFNS) For registration as a dentist Other
*Why are you taking the test? – Other
*Which country are you applying to/intending to go to? – Other
18) Wheare are you currently studying English (if applicable)?
*Do you have a permanent disability, such as a visual, hearing or specific learning difficulty, which requires special arrangements (for example, modified material, extra time, use of technology, etc.)? – Yes *
a) Name of person/department *
Name of institution/agency/body/employer *
File/case number *
b) Name of person/department
Name of institution/agency/body/employer *
File/case number *
c) Name of person/department *
Name of institution/agency/body/employer *
File/case number *
d) Name of person/department *
Name of institution/agency/body/employer *
File/case number *
e) Name of person/department *
Name of institution/agency/body/employer *
File/case number *
Upload scan of your passport *
