TOEFLiBTScoreReinstatement.PDF

TOEFL® iBT Score Reinstatement Request Form 2006-07 For Test Takers in the People’s Republic of China ® The fee for TOEFL iBT Score Reinstatement is RMB 160.00. Plsease reinstate my scores for the test administration indicated below. All required fields must be completed.Required fields are noted with an asterisk(*). *First(Given) Name(as on photo ID): *Last(Family/Surname) Name(as on photo ID): Middle Name or Middle Initial(as on photo ID): *Address Line 1: Address Line 2: *Date of Birth *Test Date Month Day Year Month Day Year *Registration Nubmber: *E-mail Address: Signature: ___________________________ Make sure the required fees are paid at the NEEA TOEFL iBT Registration website and fax this form to :8610-8252-0250 Copyright©2006 by Educational Testing Service. All rights reserved. ETS, the ETS logo, and TOEFL are registered trademarks of Educational Testing Service.