FICHE D'INSCRIPTION DELF/ DALF (Registration form DELF DALF) PHOTO Alliance française de Chandigarh 1. Code Candidat (candidat déjà immatriculé) If you have already appeared for any of the DELF/DALF exams earlier, please use the same candidate number: Please attach photocopies of all your previous DELF/DALF certificates, your PHOTO +photo ID proof + signed rules and regulation form for DELF/DALF 0 - 2. Sexe: F M 3. Nom Candidat (Surname) : 4. Nom du père (Father’s Name ) : 5. Prénom Candidat (Name): 6. Nationalité (Nationality): 7. Langue maternelle (Mother tongue) : 8. Date de naissance (jj/mm/aaaa) (Date of Birth) : (dd/mm/yyyy) 9. Pays de naissance (Country of birth): 10. Lieu de naissance (Place of Birth): 11. Adresse candidat (Address) : 12. Code postal (Pin code): 13. Téléphone / Mobile: 14. Adresse e-mail (email) : 15. Inscription à quel examen: (Registration for which exam) A1 Junior A1 A2 B1 B2 C1 C2 16. Mentionnez le domaine pour le C1/C2 Lettres et sciences humaines Sciences Please note: All candidates will have to carry their PHOTO Identity Card in ORIGINAL on the day of the examination without which entry will not be permitted inside the Examination Hall. Unsigned forms, unsigned rules and regulation for DELF/DALF, signature with discrepancy or Incomplete forms will be rejected. IMPORTANT: I UNDERSTAND THAT IF I COME LATE FOR THE EXAM, I WILL NOT BE ALLOWED TO ENTER THE HALL Teacher’s name (if you are a student of AF de Chandigarh):_____________ Signature of candidate: _______________ DELF / DALF DAY DATE Exam fee for currently enrolled Alliance Française students Fee + service tax Exam fee for external students Exam Fee + service tax A1 Tuesday 8 March 2016 Rs 1900 + Rs 276 = Rs 2176/- Rs 4400- + Rs 638 = Rs 5038/- A2 Wednesday 9 March 2016 Rs 1900 + Rs 276 = Rs 2176/- Rs 4400- + Rs 638 = Rs 5038/- B1 Thursday 10 March 2016 Rs 2800 + Rs 406 + Rs 3206/- Rs 5500- + Rs 798 = Rs 6298/- B2 Friday 11 March 2016 Rs 2800 + Rs 406 + Rs 3206/- Rs 5500- + Rs 798 = Rs 6298/- C1 Saturday 12 March 2016 Rs 3300 + Rs 479 + Rs 3779/- Rs 6600- + Rs 957 = Rs 7557/- C2 Monday 14 March 2016 Rs 3300 + Rs 479 + Rs 3779/- Rs 6600- + Rs 957 = Rs 7557/- Receipt no. _____________Dated____________ Cash/Draft ____________Total Amount___________ If exam fee is paid by draft please make the draft in favour of Alliance Francaise payable at Chandigarh. The DELF/DALF forms sent by post should reach before the last date of registration, otherwise they will not be accepted, please send form at the following address: Alliance Française de Chandigarh, next to Hibiscus Garden, Sector 36-A, CHANDIGARH-160036. Telephone: 0172-2668627, 2647894, email: [email protected] , website: www.chandigarh.afindia.org Page 1 of 2
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FICHE D'INSCRIPTION DELF/ DALF (Registration form DELF DALF)
PHOTO
Alliance française de Chandigarh
1. Code Candidat (candidat déjà immatriculé) If you have already appeared for any of the DELF/DALF exams earlier, please use the same candidate number:
Please attach photocopies of all your previous DELF/DALF certificates, your PHOTO +photo ID proof + signed rules and regulation form for DELF/DALF
0 -
2. Sexe:
F M
3. Nom Candidat (Surname) :
4. Nom du père (Father’s Name ) :
5. Prénom Candidat (Name):
6. Nationalité (Nationality):
7. Langue maternelle (Mother tongue) :
8. Date de naissance (jj/mm/aaaa) (Date of Birth) : (dd/mm/yyyy)
9. Pays de naissance (Country of birth):
10. Lieu de naissance (Place of Birth):
11. Adresse candidat (Address) :
12. Code postal (Pin code):
13. Téléphone / Mobile:
14. Adresse e-mail (email) :
15. Inscription à quel examen: (Registration for which exam)
A1 Junior
A1 A2 B1 B2 C1 C2
16. Mentionnez le domaine pour le C1/C2 Lettres et sciences humaines Sciences
Please note: All candidates will have to carry their PHOTO Identity Card in ORIGINAL on the day of the examination without which entry will not be permitted inside the Examination Hall. Unsigned forms, unsigned rules and regulation for DELF/DALF, signature with discrepancy or Incomplete forms will be rejected. IMPORTANT: I UNDERSTAND THAT IF I COME LATE FOR THE EXAM, I WILL NOT BE ALLOWED TO ENTER THE HALL Teacher’s name (if you are a student of AF de Chandigarh):_____________ Signature of candidate: _______________
DELF / DALF
DAY
DATE
Exam fee for currently enrolled Alliance Française students Fee + service tax
Exam fee for external students Exam Fee + service tax
A1 Tuesday 8 March 2016 Rs 1900 + Rs 276 = Rs 2176/- Rs 4400- + Rs 638 = Rs 5038/- A2 Wednesday 9 March 2016 Rs 1900 + Rs 276 = Rs 2176/- Rs 4400- + Rs 638 = Rs 5038/-
B1 Thursday 10 March 2016 Rs 2800 + Rs 406 + Rs 3206/- Rs 5500- + Rs 798 = Rs 6298/-
B2 Friday 11 March 2016 Rs 2800 + Rs 406 + Rs 3206/- Rs 5500- + Rs 798 = Rs 6298/-
C1 Saturday 12 March 2016 Rs 3300 + Rs 479 + Rs 3779/- Rs 6600- + Rs 957 = Rs 7557/-
C2 Monday 14 March 2016 Rs 3300 + Rs 479 + Rs 3779/- Rs 6600- + Rs 957 = Rs 7557/-
Receipt no. _____________Dated____________ Cash/Draft ____________Total Amount___________
If exam fee is paid by draft please make the draft in favour of Alliance Francaise payable at Chandigarh. The DELF/DALF forms sent by post should reach before the last date of registration, otherwise they will not be accepted, please send form at the following address: Alliance Française de Chandigarh, next to Hibiscus Garden, Sector 36-A, CHANDIGARH-160036. Telephone: 0172-2668627, 2647894, email: [email protected], website: www.chandigarh.afindia.org
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