Once properly completed and received, this document will ...

1 Once properly completed and received, this document will be treated as CONFIDENTIAL by HKEAA. ABRSM Practical Exams Entry Form 2018 2018 ABRSM (Practical Grades 1 8 and ARSM) Please read carefully the Notes on Completion of ABRSM Practical Exams Entry Form 2018 and ABRSM Exam Information & Regulations 2018 before completing this form. 2018 ABRSM - 2018 ABRSM *Please put a where appropriate 1 Applicant (aged 18 or above) information ( 18 ) Candidates aged below 18 can apply through parent/guardian, teacher or studio/school 18 / / Adult candidates can apply themselves or apply through parent/guardian, teacher or studio/school / / * Relationship with candidate Teacher Studio/School / Candidate Parent/Guardian / Others 20 *Title Dr Mr Mrs Miss Ms 21 Please complete this form in BLOCK capital letters Surname 22 46 *Given name first Given name 48 72 (Optional ) 47 HKID no.

2 ( ) (Optional ) 319 327 Other official ID document no. (if no HKID, ) (Optional ) 328 347 Telephone no. Mobile phone no. Fax no. 77 89 263 270 90 97 E-mail 98 137 2 School/Studio information (optional) / ( ) Required only if the candidate(s) is presented by a studio or school and wishes the institution to be named on the certificate(s)

3 School / Studio / 138 177 3 Correspondence address Flat/Room Floor Block 184 187 189 191 199 202 Line 1 203 227 Line 2 228 252 Line 3 277 301 *Area Hong Kong Kowloon New Territories 253-255 *Please put a where appropriate Reminder : Have you written down the flat, the floor, the block, the name of house/building, the name of street (where appropriate) and the district of your address?

4 ? For Office use only Demand Note No. (1-5) P 1. Enter the number 1 to 8 for different grades. For other levels, please refer to the Notes 1 8 2. Candidates entering for Grade 6, 7, 8 must fill in the year they passed the Grade 5 or above Theory Exams. Candidates entering for ARSM must fill in the year they passed the Grade 8 Practical in the instrument being presented (or listed alternative). Candidates must also attach a photocopy of certificate/result slip. 6, 7, 8 5 ARSM 8 ( ) 3. Subject Codes ( ) : Enter the code number (01-83) of the instrument for each candidate ( ) (01-83) 01 Piano 05 Cello 11 Clarinet 36 Alto Saxophone 03 Violin 07 Guitar 14 Trumpet 40 Singing 04 Viola 09 Flute 32 Trombone 44 Percussion Please see the attached Notes for other subject codes 4.

5 Exam area codes : Enter the exam area code (01-11) for each candidate (01-11) Code Preferred Area 01 KLN (E) Tseung Kwan O, Kwun Tong, Wong Tai Sin, etc 02 KLN (S&W) Lok Fu, Kowloon Tong, Yau Tsim Mong, Shamshuipo, Kowloon City, etc 03 HK (C&W) Causeway Bay, Happy Valley, Wan Chai, Central, Sai Wan, etc 04 HK (E) Shau Kei Wan, Tai Koo Shing, North Point, etc 05 NT (N&TP) Fanling, Sheung Shui, Ta i P o , etc 06 NT (ST) Shatin, Ma On Shan, Fo Tan, etc 07 NT (W) Kwai Tsing, Tsuen Wan, Lai King, Mei Foo, etc 08 NT (T) Tuen Mun 09 NT (Y) Yuen Long, Tin Shui Wai, etc 10 NT (TC) Tung Chung (Candidates choosing this area may be allocated to area 07. 07 ) 11 HK (S) Aberdeen, Ap Lei Chau, Stanley, etc (Candidates choosing this area may be allocated to area 03.)

6 03 ) 5. Provide English/Cantonese interpreter service to candidate (HK$156 per candidate per exam) / ( 156 ) 6. Candidate can choose to take the exam in AM session (not applicable to bulky instrument candidates) ( ) 7. Please refer to the Notes for the arrangements for candidates with special needs 4 Candidate information 1 Surname Given name 11 30 31 50 1 Grade Given name first (Optional ) or blank 54 51 2 Year passing or above Theory (for to 8 candidates) / Year passing Gr.

7 8 Practical (for ARSM candidates) Date of birth / / (DD/MM/YYYY / / ) ( ) / (ARSM ) 61 68 128 131 HKID no. ( ) 3 Subject code ( ) 69 77 52 53 Other official ID document no. (if no HKID, ) 4 Interpreter * 55 106 125 5 Exam area code Candidate s contact tel. no. 57 58 78 85 6 Exam in AM * Preferred exam months one box only RV No. (For Office Use Only ) * or blank 59 60 April / August 2017 APR to M AY 4 5 AUG 8 AUG to SEP 8 9 SEP to OCT 9 10 OCT to EARLY/MID-NOV 10 11 / 7 Special needs (except time & place, ) 132 139 Fill in B, R, L or S only 56 2 Surname Given name 11 30 31 50 1 Grade Given name first (Optional )

8 Or blank 54 51 2 Year passing or above Theory (for to 8 candidates) / Year passing Gr. 8 Practical (for ARSM candidates) Date of birth / / (DD/MM/YYYY / / ) ( ) / (ARSM ) 61 68 128 131 HKID no. ( ) 3 Subject code ( ) 69 77 52 53 Other official ID document no. (if no HKID, ) 4 Interpreter * 55 106 125 5 Exam area code Candidate s contact tel. no. 57 58 78 85 6 Exam in AM * Preferred exam months one box only RV No.

9 (For Office Use Only ) * or blank 59 60 April / August 2017 APR to M AY 4 5 AUG 8 AUG to SEP 8 9 SEP to OCT 9 10 OCT to EARLY/MID-NOV 10 11 / 7 Special needs (except time & place, ) 132 139 Fill in B, R, L or S only 56 I declared that I am aged 18 or above. I agree that the candidate(s) presented by me can directly make application to the Authority for change of applicant ( change from teacher /studio /school / others as applicant to candidate/parent/guardian as applicant). I accept the responsibility for distributing examination related documents to candidate(s) entered by me as eff ectively as possible.

10 I accept that neither the ABRSM nor HKEAA shall be responsible for any non performance of duties where such non performance has been caused by an act of God, labour strike, natural disaster, governmental action or intervention, riot, or any other cause not reasonably foreseeable and beyond the reasonable control of the ABRSM or HKEAA. I understand that the HKEAA, including their contractors and subcontractors, shall not be liable to anyone claiming for any damages which are caused by, arising from or otherwise related to the failure of staff members, examination personnel or the examination centres to comply with the examination regulations, policies or procedures. I understand that the ABRSM Interpreter Service in Hong Kong provides for full spoken English/Cantonese translation throughout the Graded and Diploma examinations.