German Courses Exam Repetition/ Postponement Form

German Courses Exam Repetition/ Postponement Form
Language(short text)
Request to:*

Postpone an examRepeat an exam

Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Course ID Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Course Exam: (The payment decision will be made after reviewing your application.)*
prevnext( X )
A1 course Exam
$75.00



A2 course Exam
$75.00



B1 course Exam
$75.00



B2 course Exam
$75.00



C1 course Exam
$75.00



Total

$0.00
When did you take the last exam?*

MonthDayYear
Date
When was the first exam originally scheduled?*

MonthDayYear
Date
Exam Date Preferred For The A1 Exam:*
Exam Date Preferred For The A2 Exam:*
Exam Date Preferred For The B1 Exam:*
Exam Date Preferred For The B2 Exam:*
Exam Date Preferred For The C1 Exam:*
Reason:*
Have you attended the course within the last 6 months?*

YesNo
Did you score more than 50 out of 100 on your first exam attempt?*

YesNo
Did you attend more than 70% of the classes for this course?*

YesNo
Should be Empty: