2016/17 IB Exam Registration Form

 

2016/17 IB Registration Form

Clearly print your name exactly as you would like it to appear on your IB Diploma/Certificate:

 

NAME: ___________________________________________________                       Circle One:  Male        Female

Home Phone   ______________________      email address (print)___________________________________

 

Birth Date:  _____/______/19___             Last four digits of Social Security #  ____  ____  ____  ____

                        day     month    year

First Language:  ______________________          (English, Vietnamese, German, Spanish, Chinese, etc.) 

First Nationality __________________________   (United States, China, Brazil, etc.)    

Current year in school:  11th    12th

Race/Ethnicity (Circle one)                                     

American Indian/Alaska Native          Asian/Pacific Islander          Black/Non-Hispanic                                                                              

Hispanic                                                  White/Non-Hispanic           Other

English Fluency (Circle one):              Fluent                                     Limited English

Free or Reduced Lunch (circle one):      Yes      No

If you require special testing accomodations please explain briefly:  _____________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Check one of the following:

           _____  Anticipated Candidate (Juniors)

           _____  Certificated Candidate  (Junior or Senior)

           _____  Diploma Candidate  (Seniors only)

Check the blank(s) for all the IB exams that you will take in May, 2017.

_____  English  (Sr. only)                                    _____   Mathematics SL  (Calculus)          _______  Theater Arts

 

_____  History  (Sr. only)                                    _____  Mathematics HL (Sr. only)             _______  Psychology  

 

_____  Chemistry  (Sr. only)                              _____  Math Studies (Discrete Math)     ________  Film

 

_____________________________                   List the Language B (World Language) IB exam you will take in May, 2016.

_____________________________                   Extended Essay Category (Senior Diploma Candidates only)                                                                                                               

FEES DUE:  On or before Friday, November 4, 2016

PROCEDURE:  Pay at ASB Office and return this form and the ASB receipt to Mr. Joling.  Make check payable to Capital High School ASB.

AMOUNT DUE:  $ ______________    (See the back side for registration/exam fee schedule.)

I understand that the registration/exam fees are nonrefundable.  Inform Mr. Joling of any changes to your testing intentions.

_________________________________________________________                    (Student Signature)

 

_________________________________________________________                    (Parent Signature)

 

_____ Yes, as an IB parent I can help supervise a May IB subject test.

 

_____ Yes, I am able to donate $ ________ to help support the CHS IB registration scholarship fund and have added

            this amount to my registration fee.  (Thank you!)

 

IB FEE SCHEDULE FOR MAY 2016

SUBMIT FEES TO CHS ASB OFFICE BY FRIDAY, OCTOBER 30

There is a fee increase if student registers after first deadline! 


JUNIOR ANTICIPATED CANDIDATES

(11th graders intending to earn an IB Diploma in spring of 12th grade year.)

 

Exam Registration                  $ 168.00

Per Subject Test Fee              $ 116.00

One-Time Mailing Fee             $ 30.00

Sample Totals:                        1 Exam:  $314.00                             2 Exams:  $430.00

 

JUNIOR and SENIOR COURSE CANDIDATES

(No IB Diploma, but testing in spring to earn an IB Certificate in one or more IB subjects.)

NOTE:  EXAM REGISTRATION FEE APPLIES FOR CHANGING FROM 11TH GRADE ANTICIPATED TO 12TH GRADE COURSE STATUS.

 

Exam Registration                  $ 168.00

Per Subject Fee                       $ 116.00 (per test)

One-Time Mailing Fee             $ 30.00

Sample Totals:                  1 Exam:  $314.00            2 Exams:  $430.00          3 Exams:  $546.00            4 Exams:  $662.00  

 

SENIOR DIPLOMA CANDIDATES:

(Diploma candidates who take one or two IB subject tests as juniors do not pay the registration fee when they register for their remaining diploma subjects as seniors.)

Per Subject Fee                           $ 116.00 (per test)

One-Time Mailing Fee                  $ 35.00

Sample Totals:                              4 Exams:  $499.00                  5 Exams:  $615.00                 

 

Note:  Diploma candidates must also satisfy Extended Essay and CAS (Creativity, Action, Service) requirements as a condition of their diploma, but there are no additional fees associated with these requirements.  While some need-based scholarship money is available, the amount of an individual award cannot be determined until registration closes.  It is possible to pay fees in installments.  Parents are encouraged to help supervise a May IB test as a way of supporting the CHS IB program and, if possible, make a donation to the scholarship fund that helps cover IB registration fees for families in need.  Contact Mr. Herinckx for details at 596-8233 or herinckxmj@osd.wednet.edu