TSE Information and Registration Bulletin TSE.pdf · (TOEFL/TSE Services) Mail Address all...

Test of Spoken English™

Listening.Learning.

Leading. www.ets.org/tse

Information and Registration

BULLETIN

FREE COPY

2005-06Policies in this bulletin are in effect from July 2005 to June 2006.

Important!Test center and institution code lists are nowin the Learners & Test Takers section of theTSE Web site at www.ets.org/tse.

The TOEFL test is changing and will include speaking! Askyour institution if the TSE is still required.

CONTENTS

2 \ Contents www.ets.org/tse 2005—06 TSE Bulletin

Scores and Score Reports . . . . . . . . . . . 13Your TSE Score Record . . . . . . . . . . . . . . . . . 13Score Reports . . . . . . . . . . . . . . . . . . . . . . 13Passing Scores . . . . . . . . . . . . . . . . . . . . . . 13Interpreting Your TSE Score . . . . . . . . . . . . . . 13Canceling Your Score . . . . . . . . . . . . . . . . . . 13Ordering Additional Score Reports . . . . . . . . . . . 14Rescoring . . . . . . . . . . . . . . . . . . . . . . . . . 14Score Verification . . . . . . . . . . . . . . . . . . . . 14Test Score Data Retention . . . . . . . . . . . . . . . . 14Confidentiality of TSE Scores . . . . . . . . . . . . . . 14Test Question Inquiries . . . . . . . . . . . . . . . . . 14Cancellation of Scores by ETS . . . . . . . . . . . . . . 15

Code ListsList A: Department Codes . . . . . . . . . . . . . . . . 16List B: Native Country and Region Codes . . . . . . . 16List C: Native Language Codes . . . . . . . . . . . . . 17

FormsRescoring Request Form . . . . . . . . . . . . . . . . 18Score Report Request Form . . . . . . . . . . . . . . . 19

Test Dates and BackRegistration Deadlines . . . . . . . . . . . . . . . . . Cover

TSE at a Glance . . . . . . . . . . . . . . . . . . 3Registration . . . . . . . . . . . . . . . . . . . . . . . 3Test Takers With Disabilities . . . . . . . . . . . . . . 3Test Preparation Material . . . . . . . . . . . . . . . . 3On the Test Day . . . . . . . . . . . . . . . . . . . . . 3

About the TSE Test . . . . . . . . . . . . . . . . 4Web Resource Guide . . . . . . . . . . . . . . . . . . . 4

Contact Information . . . . . . . . . . . . . . . 4General Inquiries . . . . . . . . . . . . . . . . . . . . . 4Test Takers With Disabilities . . . . . . . . . . . . . . 4Test Center Complaints . . . . . . . . . . . . . . . . . 4TSE Representatives . . . . . . . . . . . . . . . . . . . 4

Registration Information . . . . . . . . . . . 5Fees for Test and Services . . . . . . . . . . . . . . . . 5Payment Policies . . . . . . . . . . . . . . . . . . . . . 5TSE Admission Ticket . . . . . . . . . . . . . . . . . . 6Photo File Record . . . . . . . . . . . . . . . . . . . . 7Rescheduling and Canceling . . . . . . . . . . . . . . 7Test Center Changes . . . . . . . . . . . . . . . . . . . 7Completing the Mail-In Registration Form . . . . . . . 8

On the Test Day . . . . . . . . . . . . . . . . . . 10Identification (ID) Requirements . . . . . . . . . . . . 10Admission to the Test Center . . . . . . . . . . . . . . 11Test Center Procedures and Regulations . . . . . . . . 11What to Take to the Test Center . . . . . . . . . . . . . 12

Educational Testing Service is an Equal Opportunity/Affirmative Action Employer. Copyright © 2005 by Educational Testing Service. All rights reserved.

EDUCATIONAL TESTING SERVICE, ETS, the ETS logos, TOEFL, the TOEFL logos, TSE, and the TSE logo are registered trademarks of Educational Testing Service.TEST OF ENGLISH AS A FOREIGN LANGUAGE and TEST OF SPOKEN ENGLISH are trademarks of Educational Testing Service. Other products and servicesmentioned herein may be trademarks of their respective owners.

Educational Testing Service (ETS) administers the test under the general direction of a board that was established by, and is affiliated with, the College Board and theGraduate Record Examinations Board. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, includingphotocopy, recording, or any information storage and retrieval system, without permission in writing from Educational Testing Service, Princeton, NJ, USA. The fees,terms, and conditions in this Bulletin are subject to change.

The TSE program does not operate, license, endorse, orrecommend any schools or study materials that claim toprepare people for the test in a short time or that promisethem high scores on the test.

® ®

In September 2005, ETS will begin a phased introduction of a new TOEFL test that willinclude speaking. Before registering, visit the Web sites of the institutions or organizationsto which you plan to send your scores to learn if the new TOEFL test can be accepted inlieu of the TSE. To find out when the new TOEFL test will be administered in your area,visit www.ets.org/toefl/nextgen/timeline.html.

TSE AT A GLANCE

2005—06 TSE Bulletin www.ets.org/tse TSE at a Glance \ 3

REGISTRATION

TEST TAKERS WITH DISABILITIES

TEST PREPARATION MATERIAL

ON THE TEST DAY

ONLINE Test takers with credit cards* can register online atwww.ets.org/tse.

� There is no extra charge for this service.

� Registration deadline dates are the same as theU.S./Canada deadlines shown on the back cover.

� Online registration is not available to test takers in India,Korea, Taiwan, and the People’s Republic of China.

MAIL Complete the registration form in the center of theBulletin and mail it to ETS in the envelope provided.

If you are testing in India, Korea, or Taiwan,you must use the country-specific registrationform and envelope provided to you by therepresentative.

� ETS is committed to serving test takers with disabilities by providing services and reasonable accommodations deemed appropriategiven the purpose of the test. Nonstandard testing accommodations are available for test takers who meet ETS eligibility criteria.For more information and registration materials, please use one of the communication methods listed on page 4, or download thematerials from the Web site (www.ets.org/tse).

� Sample test questions for the TSE are available on the Web site at www.ets.org/tse. You can also order a copy by calling OrderServices at 1-800-446-3319 (United States, U.S. Territories,* Canada)

1-609-771-7243 (all other locations)

� Report to the test center no later than the time printed on your admission ticket. If you arrive late, you may not be admitted, andyour test fee will be forfeited.

� ID requirements (page 10)� Test center procedures and regulations (page 11)� The entire test session is approximately 20 minutes long.

There are two ways to register for the TSE test: by mail and online via the Internet. You CANNOT register by cable, telephone, fax, personal letter, or email.

See pages 5-10 for detailed information about test registration.

* American Samoa, Guam, Puerto Rico, and U.S. Virgin Islands.

* VISA, MasterCard, American Express, JCB, and Discover credit cards are accepted.

Visit the TSE Web site at www.ets.org/tse

for up-to-date information.

Web Resource GuideThe official Web site of the TSE program — www.ets.org/tse — hasmany resources you may find helpful.� Sample TSE questions � Testing tips� Scoring information � Frequently asked questions

IMPORTANT: The TSE test is NOT administered as part of the TOEFL test. It is administered separately.

Telephone 1-877-863-3546 (United States, Canada,American Samoa, Guam, U.S. Virgin Islands,Puerto Rico)1-609-771-7100 (all other locations)Monday–Friday, between 8 a.m. and 8 p.m.,New York time, for recorded information orpersonal assistance.

Fax1-609-771-7500

TEST TAKERS WITH DISABILITIESMail

TSE Disability Services Educational Testing ServicePO Box 6054Princeton, NJ 08541, USA

Telephone1-866-387-8602 (United States, Canada,American Samoa, Guam, U.S. Virgin Islands,Puerto Rico)1-609-771-7780 (all other locations)

TTY1-609-771-7714

[email protected]

CONTACT INFORMATIONTEST CENTER COMPLAINTSMail

Educational Testing ServiceTest Administration ServicesPO Box 6163Princeton, NJ 08541-6163, USAAttention: TSE Complaints

Fax1-609-771-7710

TSE REPRESENTATIVESIndiaInstitute of Psychological and EducationalMeasurement (IPEM)119/25-A Mahatma Gandhi MargAllahabad, U.P.211 001, IndiaTelephone: 91-532-262-4881 or 242-1292

KoreaThe Korean-American EducationalCommission (KAEC)MPO Box 112Seoul 121-600, KoreaTelephone: 82-2-3275-4027

TaiwanChun Shin LimitedPO Box 26-204Taipei, Taiwan 106Telephone: 02-2701-8008Fax: 02-2755-2822

4 \ About the TSE Test/Contact Information www.ets.org/tse 2005—06 TSE Bulletin

ABOUT THE TSE TEST The Test of Spoken English (TSE) is administered by EducationalTesting Service (ETS) through the Test of English as a ForeignLanguage (TOEFL) program.

The primary purpose of the TSE test is to measure the ability ofnonnative speakers of English to communicate orally in English. TheTSE consists of 9 items, each of which requires examinees to performa particular speech act. Examples of these speech activities includenarrating, recommending, persuading, and giving and supporting anopinion. The test is delivered via audio-recording equipment and atest book. A recorded interviewer leads the examinee through the testand the examinee’s responses are recorded.

There are two separate registration categories within the TSE program: TSE-A and TSE-P.� TSE-A is for teaching and research assistant applicants who have

been requested to take the TSE test by the admissions office ordepartment chair of an academic institution. TSE-A is also forother undergraduate or graduate school applicants.

� TSE-P is for all other individuals, such as those who are taking theTSE test to obtain licensure or certification in a professional oroccupational field.

The TSE test is administered 12 times a year at centers aroundthe world under strict, standardized procedures designed to protectthe security of the test. Every test center is open to every properlyregistered person regardless of race, color, creed, or national origin.

If you need to communicate withTOEFL/TSE Services–Princeton, be sure toinclude the test date, center number, andregistration number printed on youradmission ticket (if you have one). Alsoinclude a telephone number at which you canbe reached during the day or an e-mailaddress. TOEFL/TSE Services–Princetonmust have this information to assist you.

TOEFL/TSE Services–Princeton willrespond by letter, e-mail, or fax to examinees’inquiries made by fax. Inquiries received byelectronic mail will be responded to by e-mail.

GENERAL INQUIRIES(TOEFL/TSE Services)MailAddress all correspondence regarding yourregistration, test center, admission ticket,score report, and the test itself to

TOEFL/TSE ServicesEducational Testing ServicePO BOX 6157Princeton, NJ 08541-6157, USA

Express Courier Delivery If you need to send a communication bycourier delivery service, address it to

TOEFL/TSE ServicesEducational Testing ServiceDistribution and Receiving Center225 Phillips BoulevardEwing, NJ 08628, USA

A new, Internet-based version of the TOEFL test, which assesses allfour basic language skills: listening, reading, writing, and speaking,will be phased-in beginning September 2005. It will be introduced inthe United States in September and will be administered in Canada,France, Germany, and Italy in October. It will be offered in the rest ofthe world in 2006. Because this new TOEFL test includes a speakingsection, institutions and agencies will no longer need to include theTSE test as a separate requirement. Before registering, visit the Websites of the institutions or organizations to which you plan to sendyour scores to learn if the new TOEFL test can be accepted in lieu ofthe TSE. To find out when the new test will be available in yourcountry, visit www.ets.org/toefl/nextgen/timeline.html or see theseparate Information and Registration Bulletin for TOEFL Internet-based testing.

Fax 1-609-771-7165

[email protected]

By sending your check, be aware that you are authorizing ETS atits discretion to use the information on your check to make a one-time electronic debit from your account for the amount of yourcheck; no additional amount will be added. If you do not havesufficient funds in your account, an additional service fee of US$20will be debited electronically from your account. Contact ETS tolearn about other payment options if you prefer not to have yourcheck used in this way.

ACCEPTABLE CURRENCIESPayments made in the following currencies must be made at the telegraphic transfer selling (TTS) exchange rate of the US dollarequivalent. A check, money order, or Eurocheck payable in any ofthese currencies must be drawn on a bank in the same country as the currency. For example, a check written in Danish kroners mustbe drawn on a bank in Denmark.

� Australian dollar � Euro � Norwegian kroner� British pound � Hong Kong dollar � Singapore dollar� Canadian dollar � Japanese yen � Swedish kroner� Danish kroner � New Zealand dollar � Swiss franc

IndiaIf you plan to take the test in India you must use the registrationform and envelope provided to you by your representative.

Read the information under Item 9, Payment, on the registrationform, and check the Schedule of Fees in Rupees below. Fill in theappropriate circle and write the correct amount (in Indian rupees)for the test.

Foreign nationals taking the test in India must pay their fees by US dollar checks payable to ETS–TSE at a bank in the UnitedStates.

Indian nationals taking the test in India should submit payment inIndian rupees through a demand draft to the Institute of Psychologicaland Educational Measurement (IPEM) office in Allahabad.

The option to pay the fees in rupees is available to Indiannationals only.

Because the US dollar exchange rate frequently changes, it is notpossible to determine what the rupee equivalent of the prescribed feewould be on the day your fee is transferred to ETS in the UnitedStates. Therefore, a schedule of fees according to various exchangerates is given below. Before purchasing a rupee bank draft, you mustascertain from a bank the US dollar market selling rate (not the

REGISTRATION INFORMATION

2005—06 TSE Bulletin www.ets.org/tse Registration Information \ 5

� Test centers fill up quickly. Register as soon as possible, at least four weeks before the deadline date. You cannot register atthe test center.

� Take the test as soon as possible to be sure that your choice ofinstitution or agency receives your score report in time for themto consider with your application.

� If you believe you should not be required to take the test, writedirectly to the institutions to which you are applying. Do NOTwrite to TOEFL/TSE Services–Princeton.

� The TSE registration form is NOT an application for admission toany institution. You must send separate application papers to eachinstitution.

� You may not take the test in the morning and afternoon sessionson the same date.

Fees for Test and ServicesUS$125 Test of Spoken EnglishUS$17 Additional Score Report Requests (per recipient)US$50 TSE Rescoring RequestUS$20 Fee for returned check or declined credit card

Fees are subject to change without notice. Taxes will be added whereapplicable. In Canada, add GST/HST (Reg. #131414468RT) and QST(if applicable) (Reg. #1087967545) to total remittance.

Payment PoliciesAll test payments must be made in full, have the correct numeric andwritten dollar amount, and have appropriate signature(s). Postdatedchecks will not be accepted. Bank drafts, money orders, checks, andEurochecks in US dollars must be drawn on banks in the UnitedStates. The bank name and its address should be preprinted on theface of the check. Checks in Canadian dollars must be drawn onbanks in Canada at the prevailing rate of the US dollar plusGST/HST/QST. If you do not submit the correct fee, your registrationor request for service will be returned. Scores will not be released if apayment is returned for any reason.

You will not receive a receipt for your test payment. Youradmission ticket will be your receipt.

Rs. 38.00 — 38.19 4775.00Rs. 38.20 — 38.39 4800.00Rs. 38.40 — 38.59 4825.00Rs. 38.60 — 38.79 4850.00Rs. 38.80 — 38.99 4875.00Rs. 39.00 — 39.19 4900.00Rs. 39.20 — 39.39 4925.00Rs. 39.40 — 39.59 4950.00Rs. 39.60 — 39.79 4975.00Rs. 39.80 — 39.99 5000.00Rs. 40.00 — 40.19 5025.00Rs. 40.20 — 40.39 5050.00Rs. 40.40 — 40.59 5075.00Rs. 40.60 — 40.79 5100.00Rs. 40.80 — 40.99 5125.00Rs. 41.00 — 41.19 5150.00Rs. 41.20 — 41.39 5175.00Rs. 41.40 — 41.59 5200.00Rs. 41.60 — 41.79 5225.00Rs. 41.80 — 41.99 5250.00

TSE TEST FEE(US$125)

T.T. Selling Rate Range in Rupees for one US dollar


TSE TEST FEE(US$125)

TSE T.T. Selling Rate Range in Rupees for one US dollar


TEST FEE (US$125)T.T. Selling Rate Range in Rupees for one US dollar

SCHEDULE OF FEES IN RUPEES (ACCORDING TO BANK’S US DOLLAR T.T. SELLING RATE FOR CANDIDATES IN INDIA)

buying rate) on that day. Make sure the bank gives you the dollarmarket selling rate in terms of rupees per US dollar. If the bankinsists on quoting the exchange rate in terms of dollars per hundredrupees, you must convert the same to rupees per dollar. Then, fromthe schedule on page 5, determine the actual amount you have to pay in rupees.

Please note that if you send an amount less than what you shouldhave sent according to the schedule of fees, you will not beregistered, but the excess amount will not be refunded because of thetime, labor, and expense involved in making refunds. You must,therefore, send the correct fee according to the schedule.

How to Pay Your Fees to IPEMIf you are an Indian national, you must pay your fee with a crossedrupee bank draft. No other form of payment will be accepted. Thebank draft should be made payable to “IPEM” (do not write TSE oranything else) and should preferably be issued by the State Bank ofIndia on its main branch at Allahabad. If there is no State Bank ofIndia in your city, the draft should be issued only by a bank that has abranch in Allahabad. A State Bank of India draft must bear thecorrect code number, which is “0006” for the Allahabad main branch.Also make sure that the draft has been signed by the appropriateofficer(s). If the draft is made out incorrectly, your registration formsand fee will be returned.

Personal checks or dollar checks drawn on foreign banks cannotbe accepted from Indian nationals. If a person residing abroad wishesto pay your fee, ask that person to send the money to you so that youcan have a bank draft made out in Indian rupees.

Be sure to write your name (print, do not sign, and use pencil,not ink) on the back of the bank draft and enclose it with yourcompleted registration forms. If full payment is not enclosed, yourregistration forms will be returned to you.

Make sure you send your fee as per the Schedule of Fees on page 5 and not according to the exact calculations; otherwise you willnot be registered. When calculating your test fee, you must use theUS dollar market selling rate and not the official RBI rate.

NOTE: If the exchange rate exceeds Rs. 49.99, see theSupplementary TSE Fee Schedule on the reverse of theSupplementary India Registration Form.

How to Complete the India Registration FormYou must complete this form with an ink or ballpoint pen or with a typewriter.

You must also fill in the information asked for in the “ExamineeDeclaration.” All Indian nationals must read the declarationstatement carefully and sign it. Foreign nationals must also completeall entries, but they are not required to sign the declaration.

KoreaIf you plan to take the test in Korea, you must use the registrationform in the envelope marked “For Testing in Korea only.”� Read “Payment Policies” on page 5.� Payments for TSE in Korea must be made in US dollars in the

form of a money order or check issued by a bank and payable to ETS-TSE.

� Complete Item 9 on the registration form by filling in theappropriate circle and writing the correct amount in US dollars forthe test date you are requesting.

� Enter the total on the line marked Registration Fee. Then writethe amount due and fill in the appropriate circles.

6 \ Registration Information www.ets.org/tse 2005—06 TSE Bulletin

REGISTRATION INFORMATION (continued)

� Do not send cash through the mail. Cash is not acceptable forpayment.

Please be sure to write your name on the check or money order andsend it with your completed registration form to the Korean-AmericanEducational Commission (KAEC). If you do not send full payment,your registration form will be returned to you. If you do not receive anadmission ticket, you should contact KAEC before the test date toconfirm that you are registered for the test.

For more detailed information about TSE registration in Korea,refer to www.etskorea.or.kr.

TaiwanIf you plan to take the test in Taiwan, you must use the registrationform provided to you by your representative.� Read “Payment Policies” on page 5.� The payment for TSE is NT$4,600. (Test payments are subject to

change without advance notice.) Use a postal money order for yourpayment (made payable to Chun Shin Limited, P.O. Box 26-204,Taipei, Taiwan 106).

� Clip the postal money order to the upper left-hand corner of yourregistration form, and then write your postal money order numberin the boxes at the top of the form.

TSE Admission TicketYou will receive a TSE admission ticket by mail. If you have NOTreceived your ticket two weeks before the test date, contactTOEFL/TSE Services–Princeton or your local representative. See page4 for contact information.

BEFORE you go to the test center, you must make any necessarycorrections to the admission ticket and complete the attached photofile record and mailing instruction form. Do NOT separate the formsfrom the ticket. The test center supervisor will collect them. You willNOT be admitted to the center unless they are completed according tothe following instructions.

When you receive your ticket, your name will be printed on thefront of it. Check to be sure your name is spelled correctly, and exactlyas you printed it on your registration form. If your name is printed inEnglish letters on the required identification document that you willpresent at the test center (see page 10), your name must be spelled thesame way on your admission ticket. Also check to see that your birthdate, sex, and address are printed correctly.

Name changes cannot be made. Only misspellings of your namecan be corrected.

If you correct an error in the printing of your name, birth date, orsex, the test center supervisor must verify the change with theinformation on your identification document. If the correctedinformation is the same, the supervisor will sign the ticket. If thesupervisor does not sign your ticket, the change will not be made. Allcorrections are subject to approval by TOEFL/TSE Services–Princeton.Only address changes will be accepted by TOEFL/TSEServices–Princeton after the test date.

NOTE: Keep your admission ticket; you will need it at the test center.After the test, the supervisor will collect all tickets with corrections.

Also, copy and keep the registration number from your admissionticket. You must have this information if you write to TOEFL/TSEServices–Princeton.


2005—06 TSE Bulletin Registration Information \ 7

Photo File RecordBefore you report to the test center, you must do the following:� Sign the photo file record. � Attach a recent photograph of yourself (taken within the last six

months) showing only your face and shoulders. � Write your name, test date, registration number, and center

number on the back of the photograph BEFORE you glue it to thephoto file record.

� Trim your photograph so it is no larger than 2 inches � 2 inches

(5 � 5 cm) or no smaller than 1 inches � 1 inches

(3� 3 cm). It cannot be larger than the designated space.� Glue or tape your photo to the form. Do NOT use staples.

Laminated copies and photocopies are not acceptable. If you fail to submit a photo file record, your scores may not bereported and you will forfeit your testing fee.

Rescheduling and CancelingYou may NOT change your test date or cancel your registration. If you do not take the test and do not wish to register for another testdate, write “absentee credit” across the face of the admission ticketand send it to TOEFL/TSE Services–Princeton. It must be received byTOEFL/TSE Services–Princeton within 60 days after your test date. If your request arrives before this deadline, you will receive a partialcredit equivalent to US$10 approximately six to eight weeks afterreceipt of your request. The remainder of your payment will beretained by TOEFL/TSE Services–Princeton to cover expenses forprocessing your registration, ordering and shipping test materials,and holding space at the test center. Once you have been admitted to

14

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www.ets.org/tse

YOUR TEST CENTER ADDRESSTest Center Number

SEX

ADMISSIONTICKET

DIRECTIONS FOR CORRECTIONS

Your name, sex, birth date, and address onthis ticket come from your registration form. Ifthere is any error, please print the correctinformation.

If you correct an error,

● give this ticket to the test supervisor

The test supervisor will

● verify the corrected information with youridentification document

● sign this ticket

(Corrections in your name, birth date, and sexare subject to ETS approval.)

Supervisor's Signature Required(for name, sex, and birth date corrections only)

TSE� PHOTO FILE RECORDYou must present this form to the supervisor at the test center. You will not be admitted to the testingroom unless you have signed the form and attached a recent photograph of yourself.

YOUR SIGNATURE

NAME OF COUNTRYISSUING PASSPORTOR IDENTIFICATION

NUMBER ON IDENTI-FICATION DOCUMENT

TICKET REGISTRATION TEST DATE CENTERNUMBER NUMBER Month Year NUMBER SEX

NAME DATE OF BIRTH

Mo./Day/YearDate of Birth 1.

Name and Address2.

Registration No.

YOU MUST REPORT TOTHE TEST CENTER BY:

THIS IS YOUR TEST DATE:Ticket Number

You must take this photobearingidentification to the test centerwith you. You will not be admit-ted without it. The identificationmust include a recent recogniz-able photograph.

---------------------------------------------------------------------------------------------------------------------------------------Number: Name:

DETACH HERETest Date: Center:

R. O. C.

A210336520

1596601A

1596601 TAO HUEY-LIEN ELIZABE 12/10/04 L609

1596601

1596601 TAO H

TAO HUEY-LIEN ELIZABE

12 04 L609 F

09 04 77

10:20 AM NO ADMITTANCE

AFTER 10:30 AM

YOUR VALID ORIGINAL PASSPORT

(FOR EXCEPTIONS IN SPECIFIC CASES, SEE THE IDENTIFICATION

REQUIREMENTS IN THE TSE BULLETIN.)

12/10/04

L609

09/04/77

TEST CENTER

123 ALPHABET ROAD, TAIPEI

F

1596601

TAO HUEY-LIEN ELIZABE4F 60-1 ALY106 LN112HUANHO W RD SEC2YUNGHO TAIPEI 234 TAIWAN

(Seat No.) :01

the test center, you are NOT eligible for any partial credit. Cashrefunds are not available.

If you did not test but plan to register for a new test date, sendyour admission ticket (for which you will receive a creditequivalent to US$10 toward the total test payment), a completedregistration form, and the remaining test payment within 60 daysafter your original test date to TOEFL/TSE Services–Princeton.

For example, you would calculate your total payment as follows:

TSE Payment in US DollarsUS$125 test payment

� US$10 less absentee credit

US$115

Sometimes a test center may not be able to give the test on ascheduled date. This may happen because of an unforeseencircumstance, such as nonarrival of test materials, a postal strike,a natural disaster, or a political disturbance. When a center cannotadminister the test on a scheduled date, the test will be rescheduledfor another date as soon as possible. If you do not wish to test onthe new date, you may apply to TOEFL/TSE Services–Princetonwithin 60 days of the rescheduled test date for a full refund of thetest payment. Refunds are made in US dollars only.

Test Center ChangesYou should take the test at the center printed on your admissionticket. TOEFL/TSE Services–Princeton will not make changes toyour assigned test center.

If you are unable to go to the assigned center, you may go toanother test center on the date printed on your admission ticket, but there is no guarantee that space or test materials will beavailable for you.

IMPORTANT: If you do not receive an admission ticket, but have official authorization from TOEFL/TSEServices–Princeton to take the test, you must still take a recent photograph and the required identification to the testcenter. The supervisor will give you a photo file record form to complete at the center.

You must give the supervisor a recent photograph or your TSE test will not be scored.

THE PHOTOGRAPH you attach to your photo file record must be clear enough to show you as you will look on the dayof the test, for example, with the same hairstyle, with or without a beard. Your face in the photo MUST be clear enough sothere is no doubt about your identity.

EXAMPLE: September 4, 1980

� Fill in the corresponding circles.

ITEM 3. NATIVE COUNTRY CODE� Find your native country or region code in List B on page 16.� Write and fill in the three-digit number.

– If your country has recently changed its name, look for it underits former name.

– If your country or region is not listed, write in 999. � Fill in the circles.

ITEM 4. NATIVE LANGUAGE CODE � Find your native language name and code in List C on page 17.� Write and fill in the three-digit number.

– If your language is not listed, write in 999. � Fill in the circles.

ITEM 5. TEST CENTER � Use the test center list on the TSE Web site to select the center

where you would like to test.

NOTE: Not all centers are open on all dates. From the test centerlist, you must select a center scheduled to be open on the date you plan to test.

� Write in the center’s four-digit code number. – Sometimes all the centers in a geographic area are filled before

the registration deadline date. If there is no room at the center ofyour choice, TOEFL/TSE Services–Princeton will automaticallytry to register you at the center nearest to that center within 320 kilometers (200 miles).

– Write in a second choice ONLY if you are willing and able to testin another city, town, or area. Test date assignment dependsupon availability.

� Fill in the corresponding circles.� If you live within 320 kilometers (200 miles) of a center that is

open on one or more test dates, you are expected to take the test atthe established center on a date it is scheduled to be open.

� If you live more than 320 kilometers (200 miles) from a listed testcenter, ETS will consider opening a supplementary center.– Your request to open a supplementary center must be received

at TOEFL/TSE Services no later than two months before the test date.

– Be sure to include your registration form and payment with your request.

ITEM 6. TEST DATETSE administrations are scheduled for both Friday and Saturday test dates. Before you complete Item 6, decide whether you wouldlike to test at a Friday or a Saturday administration. (The format and length of the test are the same for both the Friday and Saturday administrations.)� Choose a Friday administration or a Saturday administration.

– The Friday administrations are usually in the afternoon, and the Saturday administrations are usually in the morning.

You must take your admission ticket, the required identificationdocument, and a completed photo file record. If space and testmaterials are available, you may be permitted to take the test.

If you are admitted to the new test center, you must change thetest center number that is printed on your admission ticket and yourphoto file record. The admission ticket must be given to the testcenter supervisor at the end of the test. Contact TOEFL/TSEServices–Princeton for the test center address and reporting time. Donot telephone or go to the test center before the day of the test. Thecenter will not have the information necessary to help you.

If you are not admitted to the new test center, see “Reschedulingand Canceling” on page 7.

Completing the Mail-InRegistration FormRemove the TSE registration form and envelope from the center ofthis bulletin and follow the instructions to complete the form.

NOTE: If you are testing in India, Korea, or Taiwan, you must usethe country-specific registration form and envelope provided to youby the representative.

� Use a medium-soft (#2 or HB) black lead pencil. Do not use a penor other marker. A scanning machine will read the circles you fillin. Fill them in completely so you cannot see the letter or numberinside each circle.

� Print the information in the boxes.� If you make changes, be certain to erase them completely.� Sign and date the form. This means you agree to accept the

conditions presented in this bulletin.

SIDE 1 OF REGISTRATION FORM

ITEM 1. NAMEComplete the 21 boxes for your name as follows:� Use English letters.� Print your family name (surname), given name, and middle name,

if you have one.– Spell your name exactly as it appears on your identification

document.– Leave a blank box after each name.– Use one box for each letter or hyphen; omit apostrophes.

Do not be concerned if you cannot print your entire name in the boxes.

EXAMPLE: Peter Dirk Gottschick

� Fill in the corresponding circle under each letter or hyphen.

This SAME FORM of your name will be printed on your admissionticket. You must also use this form of your name if you write toTOEFL/TSE Services–Princeton or the institutions that receive yourtest scores.

ITEM 2. DATE OF BIRTH Complete this section by using the US system of writing dates.� Write the month, day, and year of your birth.


8 \ Registration Information www.ets.org/tse 2005—06 TSE Bulletin

G O T T S C H I C K P E T E R D I R K

0 9 0 4 8 0

OTHER ACCEPTABLE FORMS OF PAYMENT � Check made payable to ETS–TSE� Canadian dollars drawn on a bank in Canada� Eurocheck in Europe (drawn on a bank in the country of the

currency)� UNESCO coupons

9A. CREDIT CARD INFORMATIONIf you are paying by credit card, write in the number of yourAmerican Express, Discover, JCB, MasterCard, or VISA card (no othercredit card may be used) and fill in the corresponding circles. Enterthe month and year of your card’s expiration date in the spacesindicated. DO NOT LEAVE BLANKS OR ADD HYPHENS. ETS willcalculate the total amount due and bill your credit card account.

NOTE: Individuals testing in India, Korea, and Taiwan cannot paywith credit cards. Please follow payment instructions on pages 5and 6.

ITEM 10. MAILING ADDRESSPrint your complete, current mailing address.

ITEM 11. DAYTIME PHONE NUMBERWrite the telephone number at which you can be reached during theday. Fill in the corresponding circle under each number. In Korea, ifyour phone number is more than 10 digits long, omit the initial “0.”

SIDE 2 OF REGISTRATION FORM10a. Print one letter or number in each box and leave a blank boxto indicate a space for the following:� your mailing or street address (including house or apartment

number if applicable) or PO box and number. Abbreviate youraddress only if necessary.

� the name of your city � the state or province, if space permitsFill in the appropriate circles.10b. Zip or postal code. Regardless of the number of digits in yourzip or postal code, start with the first box at the left. Fill in thecorresponding circle under each number.

Check your address carefully. The address you give will be used tomail your admission ticket and your examinee’s score record.

ITEM 12. COUNTRY CODE FOR MAILING ADDRESSSee list B on page 16 and then fill in the correct code for yourcountry or region.

ITEM 13. PERMISSIONFill in the appropriate circle to indicate whether you are willing tohave your test responses used in instructional, research, andinformational material produced by ETS. ETS will delete your nameand registration number before using the data.

ITEM 14. SIGNATURECopy the printed statement on the registration form in pencil and inyour own handwriting. When you finish, sign the statement in pencilas you would sign a legal identification document using Englishletters. Also write the date (month, day, and year) on which you signthe form.

2005—06 TSE Bulletin www.ets.org/tse Registration Information \ 9


– Be sure there is enough time for your registration form to bereceived before the registration deadline date for the test dateyou select.

– Be sure the center you indicated in Item 5 is giving the test onthe date you select.

� Fill in the correct circle.DO NOT REQUEST MORE THAN ONE TEST DATE ON A SINGLEREGISTRATION FORM.

ITEM 7. SEX� Fill in the appropriate circle.

ITEM 8. NEXT AVAILABLE TEST DATE/REFUNDSTRANSFER OR REFUND OPTIONS. If the center you selected is filled and there is no other center nearby, you have one of four choices:1. You can test on the next available date under either the Friday or

Saturday testing program. To do this, fill in circle #1 next to thewords “Next available Friday or Saturday date.’’ If you choose thisoption, your registration may be transferred to either a Friday orSaturday test date, depending on the availability of testing space atthe center of your choice.

2. If you wish to test only on the next available Friday date, fill incircle #2 next to the words “Next available Friday date only.” If youchoose this option, your registration may be transferred to thenext Friday date, depending on availability of testing space at thecenter of your choice.

3. If you wish to test only on the next available Saturday date, fill incircle #3 next to the words “Next available Saturday date only.” Ifyou choose this option, your registration may be transferred to thenext Saturday date, depending on availability of testing space at thecenter of your choice.

4. If you do not wish to test on any other date, fill in circle #4 next tothe words “A test payment refund.” If you choose this option, yourregistration will not be transferred to another test date, but youwill receive a refund of the total test payment and your registrationwill be canceled. Allow six to eight weeks to process your refund.Credit card accounts will be credited.

ITEM 9. PAYMENTFill in the appropriate circle in Item 9. Do not include the value of an unused admission ticket as part of the total amount.Write in the total amount due in the boxes under “Total,” and fill in the appropriate circles. Make all payments in full. See thespecific instructions on pages 5-6 if you are testing in India, Korea, or Taiwan.

Payment in US dollarsTSE Test Fee: US$125In Canada, add GST, HST, and QST to total remittance: GST/HST Reg. No. 131414468RTQST Reg. No. 1087967545The TSE fee is subject to change without notice.

Preferred Forms of Payment� Credit card — American Express®, Discover®, JCB®,

MasterCard®, or VISA®

� Money order� Bank draft (certified check)� US postal money order� Acceptable currencies listed under “Payment Policies” (page 5)� Do NOT send cash

ONLINE REGISTRATIONIf you have an American Express, VISA, JCB, MasterCard, or Discovercredit card, you may register for the TSE test at the TSE Web site,www.ets.org/tse. There is no additional charge for this service.

NOTE: Online registration is not available to test takers in India,Korea, Taiwan, and the People’s Republic of China.

Identification (ID) Requirements How to use this information: All test takers must read Part 1.Depending on whether you will be testing within or outside yourcountry of citizenship, you must also read either Part 2 or Part 3,as appropriate.

All test takers in Bangladesh, India, and Pakistan must use validpassports as their ID documents.

Part 1: Information for ALL Test Takers� You must have acceptable and valid ID with signature and

photograph to be admitted to a test center. Identificationrequirements are strictly enforced. It is your responsibility to readand understand the instructions and requirements.

� If you arrive at the test center without the required identification,the test center administrator will not admit you, you cannot test,and you will forfeit your test fee.

� When scheduling your appointment or completing yourregistration form, you must use exactly the same name thatappears on the primary identification document you will present atthe test center. If the name shown on your primary identificationdoes not match the name on your appointment record, you willnot be permitted to test.

� Only misspellings of your name can be corrected at check-in—NAME CHANGES WILL NOT BE MADE. If your name haschanged for any reason, including marriage, you still must presentprimary identification in the name under which you made theappointment, or you will not be permitted to test.

� If the test center administrator questions the ID you present, youwill be required to present additional proof of identity. If positiveconfirmation cannot be made, you may be refused admission tothe test center and will forfeit your test fee.

� Test center personnel will check your identification beforeassigning you a seat at the test center.

� Admittance to the test center does not imply that your form ofidentification is valid or that your scores will be reported. Allreported cases of questionable identification are subject to reviewand approval by the ETS Office of Testing Integrity.

10 \ Registration Information/On the Test Day www.ets.org/tse 2005—06 TSE Bulletin

REGISTRATION INFORMATION (continued)MAILING YOUR REGISTRATION FORMMail your registration form to Educational Testing Service. Use theenvelope in the center of the Bulletin or address the envelope withthe following address: ETS-TOEFL/TSE Registration, PO Box 382044,Pittsburgh, PA 15251-8044, USA. Be sure to use the correct postage.

If you are testing in India, Korea, or Taiwan, you must send yourcountry-specific registration form to the appropriate representative.See “Contact Information” on page 4.

You may take the TSE test only once on any scheduled test date.If you test more than once on a scheduled test date, only your firstsession will be reported and test fees for any additional sessions willbe forfeited. Violation of this policy may result in additional actionbeing taken.

ON THE TEST DAY Acceptable Primary Identification Documents

� passport with photograph and signature

� driver’s license with photograph and signature

� state identification with photograph and signature

� national identification with photograph and signature

� military identification with photograph and signature

Secondary Identification DocumentsIf your primary identification is missing either a photo or asignature, you must present one of the following secondary IDs inaddition to your primary ID. Secondary IDs that can be used to meetthe photograph and/or signature requirements are� a government-issued identification document that has not

expired including but not limited to passport, driver’s license, state identification, national identification, or militaryidentification. (There are some exceptions: see “UnacceptableIdentification Documents” below.)

� student ID� confirmation of identity letter from your educational institution.

(A sample letter is available on the TOEFL Web site.) The lettermust contain your name and date of birth; a recent, recognizablephotograph; your signature; the name of your school; and the dateissued. It must be typed on the original letterhead of theeducational institution you attend(ed), and the signature of theschool official and the school seal must overlap your photograph. Aletter of identity is valid for only one year after the date issued.

Unacceptable Identification Documents� any expired ID � international driver’s license� draft classification card � international student ID� credit card of any kind � notary-prepared letter or document� Social Security card � employee identification card� learner’s permit or any temporary identification document

If you cannot meet the specified ID requirements or if you have questions about ID, you must contact the ETSOffice of Testing Integrity (1-609-406-5430, fax: 1-609-406-9709, or e-mail: [email protected]) before you complete your registrationform. If you do not contact the ETS Office of Testing Integrity beforeregistering and are not admitted to the test, you will forfeit your test fee.

NOTE: Identification verification at the test center may includethumbprinting, photographing, videotaping, or another form ofelectronic ID confirmation. If you refuse to participate, you will not bepermitted to test and you will forfeit your test fee. This is in additionto the requirement that you must present acceptable and valididentification.

After you are admitted to the testing room, you may not leave andreenter before the test begins. At the end of the test, you mustremain in your seat until all test materials have been collected andaccounted for. You may NOT leave until you are dismissed by thesupervisor.

Test Center Procedures and RegulationsOn Test Day

� Dress so that you can adapt to any room temperature.

� Test centers do not have large waiting areas. Friends or relativeswho accompany you to the test center will not be permitted to waitin the test center or be in contact with you while you are takingthe test. Except for ETS-authorized observers, visitors are notallowed in the testing room while testing is in progress.

� Other than ID, personal items are not allowed in the testing room.Before the test, you will be assigned a locker or receiveinstructions from test center staff regarding where you mustdeposit items such as cell phones, pagers, handbags, and studymaterials. You may also be asked to empty your pockets. Storagespace is limited, so plan accordingly. You may not have access toyour personal items during the test or break.

� Test centers assume no responsibility for candidates’ personalbelongings.

� The test administrator/supervisor will assign you a seat.

� On occasion, weather conditions or other circumstances beyondthe test administrator’s or ETS’s control may require a delayedstart. In the event that a technical problem at the test centermakes it necessary to cancel your test session, or if it is laterdetermined that your scores could not be reported, you will beoffered the opportunity to retest free of charge or receive a fullrefund of the original test fee. In addition, you may seekreimbursement from ETS for reasonable and documentedexpenses for yourself only associated with traveling to the testcenter, even though technical problems are generally not the faultof ETS. To request reimbursement, please contact ETS (see page 4)with the following information within 30 days of your original testdate: your name, date of birth, mailing address, daytime telephonenumber, email address, original test date and registration number,and a brief description of what occurred at the test center. ETS will determine the appropriateness of the request. Approvedreimbursements will be made in U.S. dollars.

�There is no rest break during the TSE test. If you leave the roomfor any reason, you will not be able to finish the test.

ON THE TEST DAY (continued)

Part 2: If Testing WITHIN Your Country of CitizenshipOnly one form of primary identification is needed ifyour primary ID contains a photograph and signature. However, if the test administrator has any concerns with the primary ID, you will be required to present a secondaryidentification from the list on page 10.

If your primary ID does not contain your signature, you must either sign the document or present an additional ID from the list of secondary identification documents. The secondary ID cannot be expired and must contain a recent, recognizable photograph and your signature.

Part 3: If Testing OUTSIDE Your Country of CitizenshipYou MUST PRESENT YOUR PASSPORT as your primaryidentification document (citizens of European and Schengen Zonecountries, see special requirements below). If you do not meet thisrequirement, ETS may automatically cancel your test scores.

If your passport is not written in English language letters, youmust also present an additional ID from the list of secondaryidentification documents (see Part 1) that contains a recent,recognizable photo and is in English.

If your passport does not contain your signature, you must eithersign your passport or present an additional ID from the list ofsecondary identification documents.

U.S. military personnel may present their U.S. military ID cardsfor admission to test centers. If a military ID card does not contain a signature, a secondary ID is required.

European Union/Schengen Zone CountriesIf you are taking the test within a European Union or Schengen Zonecountry outside your own, you may use your valid national orEuropean identity card if you have one. The card you present mustcontain a recent, recognizable photograph, your date of birth, andyour signature. If your form of identification is not in Englishlanguage letters and the test administrator cannot read the language in which it is written, you may not be allowed to test. If your officialID does not contain your signature, you must present an additionaldocument from the list of secondary identification documents (seePart 1) that does contain your signature.

Admission to the Test CenterYou must be properly registered to be admitted to the test center.Family and/or friends are NOT permitted in the test center. Youcannot register at the test center.

The test will be given on the day and at the time and place printedon your admission ticket. The supervisor will not permit schedulechanges.

You must report to the center on time. No one will be admittedafter test materials have been distributed. Please note that on Fridaydates the test is usually given in the afternoon. On Saturday dates thetest is usually given in the morning.

The actual testing time for TSE is approximately 20 minutes, butyou should plan to be at the test center for at least 45 minutes. Extratime is required to admit examinees and to distribute and collect testmaterials.

2005—06 TSE Bulletin www.ets.org/tse On the Test Day \ 11

� removing or attempting to remove test content from the testcenter. Under no circumstances may test content or any part of thetest content be removed, reproduced, and/or disclosed by anymeans (e.g., hard copy, verbally, electronically) to any person orentity

� taking a weapon or firearm into the test center

� taking food, drink, or tobacco into the testing room

� leaving the testing room for any reason

� referring to, looking through, or working on any test, or testsection, when not authorized to do so, or working after time hasbeen called

� failing to follow any of the test administration regulationscontained in this Bulletin, given by the test administrator/supervisor, or specified in any test materials

ETS reserves the right to take all action—including, but not limitedto, barring you from future testing and/or canceling your score—forfailure to comply with test administration regulations or the testadministrator/supervisor’s directions. If your score is canceled, it willnot be reported, and your fees will not be refunded.

What to Take to the Test CenterWhen you go to the test center you must have:� Your admission ticket and your signed photo file record with a

recent photo attached, or official authorization from TOEFL/TSEServices–Princeton and a recent photo. You may not use acanceled check as proof of registration.

� Official identification. Read “Identification (ID) Requirements”(page 10) about the photobearing identification you must take tothe test center. Your identification will be checked before you areadmitted. It will also be checked at the end of the test.

� Institution codes. If you do not receive an admission ticket, takeyour list of institution codes with you.

� Watch. You may wish to take a watch with a second hand tomonitor your response time for individual questions. However,watch alarms, including those with flashing lights or alarmsounds, are not permitted.

NOTE: Cellular phones, pagers, and recording devices are notpermitted in the testing room.

Although tests are administered under strict supervision and securitymeasures, testing irregularities may sometimes occur. Please contactETS as soon as possible to report any observed behavior that maylead to an invalid score—for example, someone copying fromanother test taker, taking a test for someone else, having access totest questions before the exam, or using notes or unauthorized aids.All information will be held in strictest confidence.

Phone: 1-800-353-8570*Fax: 1-609-406-9709Email/Internet: [email protected]

* United States, Canada, American Samoa, Guam, Puerto Rico, and U.S. Virgin Islands only

DISMISSAL FROM A TEST CENTERA test administrator/supervisor is authorized to dismiss you from atest session and/or your scores may be canceled by ETS for violationssuch as, but not limited to, the following:

� attempting to take the test for someone else or having someoneelse take the test for you

� failing to provide acceptable identification and photo file record

� obtaining improper access to the test, a part of the test, orinformation about the test

� using a telephone or cellular phone during the test session orduring breaks (cell phones must be turned off and put away)

� using any aids in connection with the test, such as mechanicalpencils, pens, pagers, beepers, calculators, watch calculators,books, pamphlets, notes, rulers, highlighter pens, stereos or radioswith headphones, telephones, cell phones, watch alarms (includingthose with flashing lights or alarm sounds), stop watches,dictionaries, translators, and any hand-held electronic orphotographic device

� creating a disturbance (disruptive behavior in any form will not betolerated; the test administrator/supervisor has sole discretion indetermining what constitutes disruptive behavior)

� attempting to give or receive assistance—or otherwisecommunicate in any manner with another person about thecontent of the test during the administration, during breaks, orafter the test

� taking the test more than once on any scheduled test date

12 \ On The Test Day www.ets.org/tse 2005—06 TSE Bulletin

ON THE TEST DAY (continued)

NOTE: Scores more than two years old cannot be verified orreported to you or to institutions.

NOTE: Your score record and the documents you completed that areretained at ETS (for example, your photo file record) may bereleased to third parties, such as government agencies or parties toa lawsuit, if requested pursuant to a subpoena.

Passing ScoresThere are no passing or failing scores, as such, on the TSE test. Eachinstitution determines for itself what scores are acceptable. To learnhow scores are interpreted, contact the institutions that havereceived your test results.

Interpreting Your TSE ScoreUse the TSE Score Comparison Table to help you interpret yourscore. Assume that your score is 45. Under "Your Score" in thetable, find the score 45. In the "Percentile Rank" column, opposite45, is the number 56. This number means that you achieved a higherscore on the TSE than approximately 56 percent of all people whotook the test from July 2002 through June 2004.

Your PercentileScore Rank*

60 99

55 96

50 84

45 56

40 21

SCORES & SCORE REPORTS Your TSE Score RecordYour score record will consist of one score of communicativelanguage ability, which is reported on a scale of 20–60. Ratersevaluate each question and assign score levels using descriptors ofcommunicative effectiveness related to language task/function,coherence and use of cohesive devices, appropriateness of response toaudience/situation, and linguistic accuracy. The assigned score levelsfor each question are averaged. Because of this average, the scoresare reported in increments of five (i.e., 20, 25, 30, 35, 40, 45, 50, 60).

All TSE answers are independently scored by trained raters. Norater knows the score assigned by other raters.

Score ReportsThe TSE test payment entitles you to three copies of your testresults: an examinee’s score record for you and two official scorereports for institutions and agencies that you specify on the mailinginstruction form attached to your admission ticket. (Up to two TSEscore reports may also be sent at no additional cost, provided you listthe institutions or agencies on the mailing instruction form.) Testresults will be mailed to you and to institutions or agencies aboutfour to five weeks after you take the test. Sufficient postal deliverytime must be allowed after mailing. UNDER NO CIRCUMSTANCESCAN TEST RESULTS BE GIVEN ANY EARLIER.

Score reports may be delayed three weeks or more if yourresponses arrive late or if they were not properly recorded. If youranswers cannot be scored because of mechanical problems, you willbe offered a makeup test free of charge.

SCORE REPORT MAILING INSTRUCTION FORMTwo areas for mailing instructions are provided on the form. Fill outone area for each institution or agency to which you wish to haveyour TSE score report mailed.

First, look at the Institution Codes list on the TSE Web site. Findthe names of the institutions or agencies to which you want yourofficial score reports sent. Then copy the names and code numberson the form. If you are applying to an institution not in the list, write1000 in the institution code box.

If you do not have code numbers, you will have to complete a TSEScore Report Request Form and pay the required fee (see page 19).Follow these instructions:A. If you are applying as an undergraduate student (that is, you have

finished secondary school but have not completed your studies fora bachelor’s degree), print 00 in the boxes for department code.Your score report will be sent to the undergraduate admissionsoffice.

B. If you are applying for graduate study (that is, you have alreadyearned a bachelor’s degree at a college or university), look at ListA: Department Codes (page 16). Find the name of the departmentin which you plan to study and then write the code number onyour form. If your department is not on the list, write 99 in thespaces for department code. You must write a department codenumber so TOEFL/TSE Services–Princeton can send your scorereport to the correct office. If you do not write a department code,your official score report may be sent to the institution’sundergraduate school.

C. For an agency or an institution that is not a college or university,print 00 in the boxes for department code.

Do not fill in your address on the instruction form. Yourexaminee’s score record will automatically be mailed about onemonth after the test date to the address you gave on your registration form.

TSE SCOREYour PercentileScore Rank*

35 3

30 <1

25

20

* The percentile rank for each score point is the percentage ofexaminees scoring below that score plus one-half of the percentageof examinees who achieved that score.

Canceling Your ScoreIf you wish to cancel your score, do the following:� Notify the test center supervisor immediately following the test.

— or —Immediately after the test, contact TOEFL/TSE Services–Princeton.

Address your email or fax “Attention: TOEFL/TSE Score Cancellations.”Your communication must include your name, test date, centernumber, and registration number printed on your admission ticket. See“Contact Information” on page 4. You must follow up e-mailcommunication with a written and signed request to TOEFL/TSE ScoreCancellations, PO Box 6157, Princeton, NJ 08541-6157, USA. A faxmessage must include your signature and need not be followed by aletter.

2005—06 TSE Bulletin www.ets.org/tse Scores & Score Reports \ 13

TSE SCORE COMPARISON TABLE(based on the scores of 80,664 examinees

who took TSE from July 2002 through June 2004)

NOTE: TSE scores are measurement information and are subject toall restrictions on release of information indicated in this Bulletin.They are not the property of the examinee.

Score VerificationInstitutions are advised to request official verification of any testscore sent to them directly by examinees. If you send your examinee’sscore record to an institution and there is a difference between theofficial score recorded at ETS and the score on the score record youprovided, the institution will be requested to send ETS a copy of thescore record. At the written request of the official of the institution,ETS will report the official score, as well as any previous scoresrecorded for you within the last two years. ETS or its authorizedrepresentative will also provide information about your score at therequest of an institution or agency that has a copy of your examinee’sscore record.

Test Score Data RetentionBecause language proficiency can change considerably in a relativelyshort period, TOEFL/TSE Services–Princeton will not report or verifyscores that are more than two years old. Individually identifiable testscores are retained for only two years.

TSE test score data that may be used at any time forinformational, research, statistical, or training purposes are notindividually identifiable.

Confidentiality of TSE ScoresThe TSE program recognizes the right of examinees to privacy withregard to information that is stored in data or research files held byETS and the program’s responsibility to protect information in itsfiles from unauthorized disclosure. ETS or its authorizedrepresentative may share examinee score data with institutions oragencies for verification purposes.

Information retained in the TSE test files is the same as theinformation printed on the examinee’s score record and on theofficial score reports. Official score reports will be sent only to thoseinstitutions or agencies designated on the admission ticket by theexaminee on the day of the test, on a score report request formsubmitted at a later date, or otherwise specifically authorized by theexaminee.

The scores are not to be released by institutional recipientswithout the explicit permission of the examinees.

Test Question InquiriesLanguage specialists prepare TSE test questions. These specialistsfollow careful, standardized procedures developed to ensure that alltest material is of consistently high quality. Each question is reviewedby several members of the ETS staff.

After test questions have been reviewed and revised asappropriate, they are selectively administered in trial situations andassembled into test forms. The test forms are then reviewedaccording to established ETS and TSE program procedures to ensurethat the forms are free of cultural bias. Statistical analyses ofindividual questions, as well as of the complete tests, ensure that allitems provide appropriate measurement information.

Your request to cancel your score must be received byTOEFL/TSE Services–Princeton no later than seven days after the test date printed on your admission ticket. You may not waituntil after you have received your personal score record to cancelyour score.

NOTE: If your score is canceled it will not be reported to you or toany institution, and you will not receive a refund of your testpayment. Once a score is canceled and deleted from your permanentrecord, it cannot be reinstated and reported at a later date. If you wishto take the test again, you must complete a new registration form andmail it to TOEFL/TSE Services–Princeton with another test payment.

Ordering Additional Score ReportsUse the form on page 19 to request additional TSE official scorereports for institutions you did NOT list on the mailing instructionform(s) on the day of the test.

The form will be returned to you if you do not give completeinformation or if you do not enclose the correct fee.

Do not send a letter with this form. It will cause delay.Score reports will be mailed after the score report mailing date

(see back cover) to the institutions you have listed. UNDER NOCIRCUMSTANCES CAN SCORE REPORTS BE SENT ANY EARLIER.

Scores will be mailed within two weeks after TOEFL/TSEServices–Princeton receives your request. Sufficient postal deliverytime must be allowed after mailing.

An acknowledgment confirming that your official score reportshave been mailed will be sent to you.

RescoringWithin six months of your test date, you may request to have anadditional independent rater score your responses. Experiencedraters who did not review the responses previously will score theanswers. If your TSE score increases or decreases, you will receive arevised examinee’s score record, as will the institutions that receivedyour score. This revised score will become your official TSE score.TOEFL/TSE Services–Princeton will notify you by letter.

If you want your answers rescored, complete the form on page 18and send it, with the required fee of US$50 (made payable toETS–TSE), to TOEFL/TSE Services–Princeton, Educational TestingService, PO Box 6157, Princeton, NJ 08541-6157, USA. If you arepaying by credit card, write the number of your American Express,Discover, JCB, MasterCard, or VISA card (no other credit card may be used). Enter the month and year of your card’s expiration date inthe spaces indicated. ETS will calculate the total amount due and billyour account. You can send this form by fax. On forms sent by fax,ETS will not process any requests with incomplete credit cardinformation. If you think TOEFL/TSE did not receive this form by faxand you attempt to send the information again, write “DUPLICATE”in large letters on repeat requests. This will help avoid extraprocessing by TSE Services and unnecessary charges to your creditcard. See pages 5–6 for acceptable payment options in your country.

NOTE: The results of the rescoring will be available about threeweeks after the receipt at TOEFL/TSE Services–Princeton of yourTSE Rescoring Request Form and fee.

14 \ Scores & Score Reports www.ets.org/tse 2005—06 TSE Bulletin

SCORES & SCORE REPORTS (continued)

SCORES & SCORE REPORTS (continued)

Testing Irregularities“Testing irregularities” refers to problems with the administration ofa test. When testing irregularities occur, they may affect an individualor groups of test takers. Such problems include, without limitation,administrative errors (such as improper timing, improper seating,defective materials, and defective equipment); improper access to testcontent; and other disruptions of test administrations (such asnatural disasters and other emergencies). When testing irregularitiesoccur, ETS may decline to score the test or may cancel the test score.When in ETS’s judgment it is appropriate to do so, ETS gives affectedtest takers the opportunity to take the test again as soon as possiblewithout charge.

Identification DiscrepanciesWhen, in ETS’s judgment or the judgment of test center personnel,there is a discrepancy in a test taker’s identification, the test takermay be dismissed from the test center; in addition, ETS may declineto score the test or may cancel the test score.

MisconductWhen ETS or test center personnel find out that there is misconductin connection with a test, the test taker may be dismissed from thetest center or ETS may decline to score the test, or may cancel thetest score. Misconduct includes but is not limited to noncompliancewith the “Test Center Procedures and Regulations” found on pages 11–12 of the Bulletin.

Invalid ScoresETS may also cancel scores if, in its judgment, there is substantialevidence that they are invalid for any other reason. Evidence ofinvalid scores may include, without limitation, discrepant handwriting,unusual answer patterns, and inconsistent performance on differentparts of the test. Before canceling scores pursuant to this paragraph,ETS notifies the test taker in writing about its concerns, gives thetest taker an opportunity to submit information that addresses ETS’sconcerns, considers any such information submitted, and offers thetest taker a choice of options. The options include voluntary scorecancellation, a free retest, or arbitration in accordance with ETS’sstandard Arbitration Agreement. In addition, the test taker is sent acopy of a booklet, Why and How Educational Testing ServiceQuestions Test Scores, which explains this process in greater detail.(This booklet is available to any test taker at any time on request.)

Although ETS employs extensive quality control checksthroughout the development of test questions and the preparation offinal tests, typographical errors or flaws in questions can occur onrare occasions. If you suspect a problem and want to question a testitem for any reason, notify the test supervisor before you leave thetest site. Then you can write or send a fax to TOEFL Test QuestionInquiries (42-N-208), Educational Testing Service, Rosedale Road,Princeton, NJ 08541-0001, USA (fax: 609-683-2600) immediately aftertaking the test.

Please include the name of the test, the test date, the name of thecenter where the test was taken, and, if possible, the number of thetest item being questioned.

If you have a complaint about the testing facilities or thesupervisor, write to Test Administration Services within three daysafter the test date. Be sure to give the date of the test, the name ofthe test center, and the city and country in which you tested. Write toTest Administration Services, Educational Testing Service, PO Box 6163, Princeton, NJ 08541-6163, USA (fax: 609-771-7710).

Cancellation of Scores by ETSEducational Testing Service strives to report scores that accuratelyreflect the performance of every test taker. Accordingly, ETS’sstandards and procedures for administering tests have two primarygoals: giving test takers equivalent opportunities to demonstratetheir abilities, and preventing some test takers from gaining anunfair advantage over others. To promote these objectives, ETSreserves the right to cancel any test score when, in ETS’s judgment, atesting irregularity occurs, there is an apparent discrepancy in a testtaker’s identification, the test taker engages in misconduct, or thescore is invalid for another reason. Reviews of scores by ETS areconfidential. When, for any of the above reasons, ETS cancels a testscore that has already been reported, it notifies score recipients thatthe score has been canceled, but it does not disclose the reason forcancellation except when authorized to do so by the test taker and incertain group cases.

2005—06 TSE Bulletin www.ets.org/tse Scores & Score Reports \ 15

16 \Department Codes/Native Country & Region Codes www.ets.org/tse 2005—06 TSE Bulletin

LIST A: DEPARTMENT CODESDep

artm

ent

Code

s / N

ativ

e Co

untr

y &

Reg

ion

Code

s

LIST B: NATIVE COUNTRY & REGION CODES

This list is only for students applying for graduate study. If you are not applying for graduate study, you must fill in 00 as the department code for each institution oragency you list.

02 - Graduate Schools of Management 03 - Law Schools

Other Graduate Schools: If you are applying for graduate study in a field other than business or law, copy the appropriate code from the list below.

HUMANITIES 11 Archaeology 12 Architecture 26 Art History 13 Classical Languages 28 Comparative

Literature 53 Dramatic Arts 14 English 29 Far Eastern

Languages and Literature

15 Fine Arts, Art, Design 16 French 17 German 04 Linguistics 19 Music 57 Near Eastern

Languages and Literature

20 Philosophy 21 Religious Studies or

Religion

22 Russian/SlavicStudies

23 Spanish 24 Speech 10 Other foreign

languages 98 Other humanities

SOCIAL SCIENCES27 American Studies 81 Anthropology 82 Business and

Commerce 83 Communications 84 Economics 85 Education (including

M.A. in Teaching) 01 Educational

Administration 70 Geography 92 Government 86 History 87 Industrial Relations

and Personnel

88 InternationalRelations

18 Journalism90 Library Science91 Physical Education97 Planning (City,

Community, Urban,Regional)

89 Political Science93 Psychology, Clinical09 Psychology,

Educational58 Psychology,

Experimental/Developmental

79 Psychology, Social08 Psychology, other94 Public Administration50 Public Health95 Social Work96 Sociology80 Other social sciences

BIOLOGICAL SCIENCES31 Agriculture32 Anatomy05 Audiology33 Bacteriology34 Biochemistry35 Biology45 Biomedical Sciences36 Biophysics37 Botany38 Dentistry39 Entomology46 Environmental

Science40 Forestry06 Genetics41 Home Economics25 Hospital and Health

ServicesAdministration

42 Medicine07 Microbiology

74 Molecular andCellular Biology

43 Nursing77 Nutrition44 Occupational Therapy56 Pathology47 Pharmacy48 Physical Therapy49 Physiology55 Speech-Language

Pathology51 Veterinary Medicine52 Zoology30 Other biological

sciences

PHYSICAL SCIENCES54 Applied Mathematics61 Astronomy62 Chemistry78 Computer Sciences63 Engineering,

Aeronautical

64 Engineering,Chemical

65 Engineering, Civil66 Engineering,

Electrical67 Engineering,

Industrial68 Engineering,

Mechanical69 Engineering, other71 Geology72 Mathematics73 Metallurgy75 Oceanography76 Physics59 Statistics60 Other physical

sciences

Use 99 for any depart-ment not listed.

001 Afghanistan 003 Albania 005 Algeria 007 American Samoa 008 Andorra 010 Angola011 Anguilla 012 Antigua and

Barbuda 015 Argentina 016 Armenia017 Aruba 020 Australia 025 Austria 029 Azerbaijan030 Azores 035 Bahamas 040 Bahrain 045 Bangladesh 050 Barbados 094 Belarus055 Belgium 056 Belize058 Benin060 Bermuda063 Bhutan065 Bolivia069 Bosnia and

Herzegovina070 Botswana075 Brazil077 British Virgin

Islands081 Brunei Darussalam085 Bulgaria593 Burkina Faso092 Burundi307 Cambodia095 Cameroon100 Canada106 Cape Verde110 Cayman Islands

113 Central AfricanRepublic

114 Chad115 Chile457 China, People’s

Republic of120 Colombia122 Comoros630 Congo-DRC

(Formerly Zaire)125 Congo Republic126 Cook Islands130 Costa Rica290 Côte d’lvoire

(Ivory Coast)133 Croatia135 Cuba140 Cyprus142 Czech Republic150 Denmark153 Djibouti154 Dominica,

Commonwealthof

155 Dominican Republic165 Ecuador170 Egypt175 El Salvador180 England183 Equatorial Guinea182 Eritrea184 Estonia185 Ethiopia187 Faroe Island190 Fiji195 Finland200 France203 French Guiana202 French Polynesia204 Gabon205 Gambia, The206 Gaza Strip

208 Georgia210 Germany215 Ghana220 Greece225 Greenland227 Grenada228 Guadeloupe229 Guam230 Guatemala233 Guinea234 Guinea-Bissau235 Guyana240 Haiti245 Honduras250 Hong Kong251 Hungary255 Iceland260 India265 Indonesia270 Iran273 Iraq275 Ireland277 Isle of Man280 Israel285 Italy295 Jamaica300 Japan305 Jordan308 Kazakstan310 Kenya312 Kiribati314 Korea (DPR)315 Korea (ROK)320 Kuwait323 Kyrgyzstan325 Laos328 Latvia330 Lebanon333 Lesotho335 Liberia340 Libya343 Liechtenstein

344 Lithuania345 Luxembourg347 Macau348 Macedonia, former

YugoslavRepublic of

350 Madagascar353 Madeira Islands355 Malawi360 Malaysia361 Maldives363 Mali365 Malta367 Northern Mariana

Islands368 Marshall Islands366 Martinique 369 Mauritania 370 Mauritius 375 Mexico107 Micronesia,

Federated Statesof

376 Moldova378 Monaco 379 Mongolia381 Montserrat 380 Morocco 385 Mozambique 090 Myanmar (Burma)388 Namibia 386 Nauru 387 Nepal 390 Netherlands 395 Netherlands

Antilles 396 New Caledonia 405 New Zealand 420 Nicaragua 425 Niger 430 Nigeria 433 Niue Island

434 Northern Ireland 435 Norway 443 Oman 445 Pakistan447 Palau 450 Panama 400 Papua New Guinea 455 Paraguay 460 Peru 465 Philippines 470 Poland 475 Portugal 474 Puerto Rico 477 Qatar 482 Reunion483 Romania 484 Russia487 Rwanda 486 St. Kitts and Nevis 521 St. Lucia 522 St. Vincent and the

Grenadines 488 San Marino 489 Sao Tome and

Principe 490 Saudi Arabia 495 Scotland 497 Senegal 498 Seychelles 500 Sierra Leone505 Singapore503 Slovakia504 Slovenia506 Solomon Islands507 Somalia510 South Africa515 Spain520 Sri Lanka525 Sudan527 Suriname530 Swaziland535 Sweden

540 Switzerland545 Syria550 Tahiti555 Taiwan556 Tajikistan560 Tanzania565 Thailand567 Togo570 Tonga575 Trinidad and

Tobago580 Tunisia584 Turkmenistan585 Turkey586 Turks and Caicos

Islands587 Tuvalu590 Uganda589 Ukraine591 United Arab

Emirates588 United Kingdom*592 United States of

America607 U.S. Virgin Islands595 Uruguay594 Uzbekistan596 Vanuatu597 Vatican City600 Venezuela605 Vietnam610 Wales611 West Bank620 Samoa623 Yemen625 Yugoslavia635 Zambia480 Zimbabwe

Use 999 for any country/region not listed.

LIST C: NATIVE LANGUAGE CODESN

ative Languag

e Codes

101 Afrikaans 405 Albanian107 Amharic501 Arabic401 Armenian301 Assamese402 Azeri403 Bashkir404 Basque (Euskara)408 Belarusian111 Bemba305 Bengali113 Berber302 Bhili303 Bikol407 Bulgarian307 Burmese317 Buyi410 Catalan312 Cebuano (Visayan)114 Chichewa315 Chinese412 Chuvash413 Czech416 Danish

325 Dong419 Dutch116 Efik-lbibio422 English425 Estonian119 Ewe504 Farsi (Persian)601 Fijian428 Finnish434 French122 Fula (Peulh)436 Galician151 Ganda (Luganda)437 German438 Georgian440 Greek201 Guarani320 Gujarati133 Hausa507 Hebrew323 Hindi443 Hungarian (Magyar)136 Ibo (Igbo)447 Icelandic326 llocano

328 Indonesian450 Italian331 Japanese332 Javanese335 Kannada

(Kanarese)121 Kanuri338 Kashmiri339 Kazakh310 Khmer142 Kikuyu123 Kinyarwanda149 Kirundi352 Konkani340 Korean342 Kurdish359 Kurukh (Oraon)604 Kusaiean343 Lao452 Latvian (Lettish)145 Lingala453 Lithuanian148 Luba-Lulua153 Luo454 Macedonian

375 Madurese156 Malagasy345 Malay346 Malayalam159 Malinke-Bambara-

Dyula455 Maltese348 Marathi607 Marshallese162 Mende362 Minangkabau341 Mongolian128 Moré608 Nauran351 Nepali456 Norwegian131 Nyanja353 Oriya127 Oromo610 Palauan319 Panay-Hiligaynon357 Pashtu611 Pidgin459 Polish613 Ponapean

461 Portuguese355 Punjabi464 Romanian467 Russian616 Samoan372 Santali470 Serbo-Croatian166 Sesotho167 Setswana170 Shona360 Sindhi361 Sinhala169 Siswati473 Slovak474 Slovenian173 Somali478 Spanish364 Sundanese176 Swahili481 Swedish367 Tagalog482 Tajik370 Tamil371 Tatar373 Telugu

376 Thai379 Tibetan179 Tigrinya622 Tongan625 Trukese382 Tulu484 Turkish483 Turkmen182 Twi368 Uighur487 Ukrainian628 Ulithian385 Urdu495 Uzbek388 Vietnamese185 Wolof178 Xhosa631 Yapese393 Yi442 Yiddish188 Yoruba396 Zhuang191 Zulu

Use 999 for any language not listed.

Native Lang

uage Codes

2005—06 TSE Bulletin www.ets.org/tse Native Language Codes \ 17

the month and year of your card’s expiration date in the spaces indi-cated. ETS will calculate the total amount due and bill your account.You can send this form by fax. On forms sent by fax, ETS will notprocess any requests with incomplete credit card information. If youthink TOEFL/TSE did not receive this form by fax and you attempt tosend the information again, write “DUPLICATE” in large letters onrepeat requests. This will help avoid extra processing by TSE Servicesand unnecessary charges to your credit card. See pages 5–6 foracceptable payment options.

NOTE: The results of the rescoring will be available about threeweeks after the receipt at TOEFL/TSE Services–Princeton of yourTSE Rescoring Request Form and fee.

18 \ Forms www.ets.org/tse 2005—06 TSE Bulletin

Form

s

RESCORING REQUEST FORMTEST DATE CENTER NUMBER

NAME

REGISTRATION NUMBER BIRTH DATE

Check if paying by: American Express MasterCard VISADiscover JCBCard Number: Expiration Date.

IF PAYING BY CREDIT CARD, YOU CAN SEND THIS FORM BY FAX TO 1-609-771-7500.

Authorization to Convert Your Check to an Electronic Funds Transfer DebitBy sending your check to us, you authorize ETS to convert the check into an electronic fund transfer.Please be aware that your bank account may be debited as soon as the same day we receive your payment and you will not receive a canceled check. If you do not have sufficient funds in your account, anadditional service fee of US$20 will be debited electronically from your account.

Fees are subject to change without notice. Taxes will be added where applicable.In Canada, add GST/HST (Reg. #131414468RT)and QST (if applicable) (Reg. #1087967545) to total remittance.

Copyright © 2005 by Educational Testing Service, Princeton, NJ, USAThis form may be photocopied.

(Effective July 1, 2005)

EnclosedUS$50

TSE test date indicated below I request that the following be rescored:

NUMBER ANDSTREET ADDRESS

CITY & STATEOR PROVINCE

ZIP OR POSTAL CODE NAME

TOEFL/TSE Services–PrincetonEducational Testing ServicePO Box 6157Princeton, NJ 08541-6157

NUMBER ANDSTREET ADDRESS

CITY & STATEOR PROVINCE

COUNTRY

ZIP OR POSTAL CODE

SIGNATURE

Mailing Slip for Rescoring Results – Do Not Detach

Print your name and address below.

729-05

CUT HERE ✁

TSE Request for RescoringWithin six months of your test date, you may request to have an additional independent rater score your responses. Experiencedraters who did not review the responses previously will score theanswers. If your TSE score increases or decreases, you will receive arevised examinee’s score record, as will the institutions that receivedyour score. This revised score will become your official TSE score.TOEFL/TSE Services–Princeton will notify you by letter.

If you want your answers rescored, complete the form below andsend it, with the required fee of US$50 (made payable to ETS–TSE),to TOEFL/TSE Services–Princeton, Educational Testing Service, POBox 6157, Princeton, NJ 08541-6157, USA. If you are paying by creditcard, write the number of your American Express, Discover, JCB,MasterCard, or VISA card (no other credit card may be used). Enter

2005—06 TSE Bulletin www.ets.org/tse Forms \ 19

Forms

PaymentSee pages 5–6 for acceptable payment options in your country. 1. You may pay in US dollars with a credit card or a check drawn ona US bank, or a money order. Do not send cash. Receipts for bankchecks or money orders are not acceptable. The actual negotiablecheck or money order must be made payable to ETS–TSE andaccompany the form.

If you are paying by credit card, write in the number of yourAmerican Express, Discover, JCB, MasterCard, or VISA card (no othercredit card may be used). Enter the month and year of your card’sexpiration date in the spaces indicated. The total amount due will becalculated automatically at ETS and billed to your account.2. If you do not send enough money, the TSE office will send reportsonly to as many institutions as you paid for, no matter how many yourequested. (Fees are subject to change without notice.)3. Sign and date the form before mailing.4. Mail this form and payment to ETS-ASR/TSE, PO Box 371463,Pittsburgh, PA 15250-7463, USA.5. If you are paying by credit card, this form may be faxed. Faxedrequests will not be processed unless complete credit card informa-tion is provided. The fax number is 609-771-7500.

How to Complete the Score ReportRequest Form

Fill in your registration number, name, date of birth, test date,and center number.

To order an official score report for an institution or agency, lookat the Institution Codes list on the TSE Web site. Find the name ofthe institution to which you want your score report sent. Copy thecode number in the space provided. Then print, IN ENGLISH LET-TERS, the name of the institution. If the institution is not on the list,write 1000 in the institution code box and print the name to theright.

Next, look at List A: Department Codes (page 16). Write the two-digit code number in the space provided. Then print the name of thedepartment. If your department is not listed, write 99 in the space fordepartment code. You must write a department code number so theTSE office can send your score report to the office the institution hasnamed to receive TSE score reports. For an agency or institution thatis not a college or university, print 00 in the boxes for department code.

Also print, IN ENGLISH LETTERS, the institution or agency’sname, department name, and mailing address. Include the city andcountry.

CUT HERE ✁

Scores more than two years old cannot be reported or verified.SCORE REPORT REQUEST FORM729-05

Check the appropriate box to show the number of reports you are requesting. Scores will be mailed two weeks after receipt of request by TSE or after scores become available.

Check if paying by: American Express MasterCard VISADiscover JCBCard Number: Expiration Date.Amount Due in US Dollars:

$34 for 2$17 for 1

REGISTRATION NUMBERfor the test date you indicate

Month Date Year DATE OF BIRTH

Month Date TEST DATE

CENTERNUMBER

NAME: Print your family name (surname), given name, then middle name, if you have one. Leave a blank space between names.

ETS USE ONLY

INSTITUTION CODE

NUMBER AND STREET ADDRESS

CITY

COUNTRY

DISTRICT, PROVINCE, STATE

ZIP CODE / POSTAL CODE

NAME OF INSTITUTION

DEPARTMENT CODE

If your mailing address has changed since the test date you indicated on this form, print your name and new address in these boxes. Use English letters. Leave a blank box after each complete number or word.

NAME

MAILING OR STREET ADDRESS

CITY / STATE ORPROVINCE

COUNTRY / ZIP ORPOSTAL CODE

INSTITUTION CODE

NUMBER AND STREET ADDRESS

CITY

COUNTRY

DISTRICT, PROVINCE, STATE

ZIP CODE / POSTAL CODE

NAME OF INSTITUTION

DEPARTMENT CODE

IF PAYING BY CREDIT CARD, YOU CAN SEND THIS FORM BY FAX TO 1-609-771-7500.

Fees are subject to change without notice. Taxes will be added where applicable.

In Canada, add GST/HST (Reg. #131414468RT)and QST (if applicable) (Reg. #1087967545) to total remittance.

Authorization to Convert Your Check to an Electronic Funds Transfer DebitBy sending your check to us, you authorize ETS to convert the check into an electronic fund transfer. Please be aware that your bank account may be debited as soon as the same day we receive your payment and you will not receive a canceled check.If you do not have sufficient funds in your account, an additional service fee of US$20 will be debited electronically from your account.

YOUR SIGNATURE DATE

Copyright © 2005 by Educational Testing Service,Princeton, NJ, USAThis form may be photocopied.

(Effective July 1, 2005)

NOTE: Your Score Report Request Form will be processed upon receipt, and a charge will be made to your credit card. If you think yourfaxed form may not have been received by TOEFL/TSE Services and you attempt to send the information again, write “DUPLICATE” inlarge letters on all repeat requests. This will help avoid extra processing by TSE Services and unnecessary charges to your credit card.You cannot delete or change designated institutions after the form has been submitted.

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