ID116 KALAM KUDUS CHRISTIAN SCHOOL SURAKARTA INDONESIA

CAMBRIDGE EXAMINATION REGISTRATION FORM

PRIVATE CANDIDATES

November 2020 Examination Session

STANDARD REGISTRATION PERIOD

10 August 2020

LATE REGISTRATION PERIOD

11 August 2020 to 20 September 2020

(Late fee of IDR 1,685,000 per subject applies during this period)

IMPORTANT REMINDER

Please note that NO refund, transfer or postponement is allowed after registration

KALAM KUDUS CHRISTIAN

CENTRE NAME SCHOOL SURAKARTA CENTRE NUMBER ID116
INDONESIA

Full Name as in KTP (National ID for Indonesian)/ Passport

(Please attach a copy of your KTP or Passport for International Student)

KTP / Passport No Previous Candidate Number

Gender Previous Centre Number

Date of birth English first language? Yes / No

Full Address

Contact Numbers
(Home) (Mobile) (Email)

Application for Access Arrangements

[1] Place a tick (✓) in the box against the requested access arrangement.
[2] Attach the mandatory supporting documents (e.g. comprehensive medical report).
[3] November series application deadline is 15 August 2020.
[4] Attach candidate's passport photo. 4 x 6 via email

ID116 - Kalam Kudus Christian School Surakarta Indonesia

AM. Sangaji Street No. 24, Gajahan, Pasar Kliwon, Surakarta, Central Java, Indonesia. Phone +62271666248
email : smp.ip@kalamkudussolo.sch.id
Please select subjects and appropriate option codes by placing a (✓) in the boxes below.
International General Certificate of Secondary Education (IGCSE)
Code Subject Paper no & Component information Option Fee (IDR) ✓
12: Geographical Themes 12
0606 Geography 22: Geographical Skills 22 BY 12, 22, 42 Rp 2.680.000
42: Alternative to Coursework 42

BY 22, 42, 52 (Extended) Rp 2.680.000

12: Multiple Choice (Core) 12 Rp 2.680.000
CY 22, 42, 62 (Extended)
22: Multiple Choice (Extended) 22
32: Theory (Core) 32 FY 12, 32, 52 (Core) Rp 2.680.000
0610 Biology 42: Theory (Extended) 42
52: Practical Test 52 GY 12, 32, 62 (Core) Rp 2.680.000
62: Alternative to Practical 62
*) additional fee for
Rp 1.450.000
practical

Bahasa 01: Reading and Understanding 01, 02, 03 Rp 2.680.000

0538 Indonesian 02: Reading and Writing
03: Speaking and Responding *) additional fee for
Rp 1.450.000
speaking

12: Reading & Wriring (Core) 12 AY 12, 32, 52 Rp 2.680.000

English as a 22: Reading & Writing (Extended) 22
Second Language 32: Listening (Core) 32 FY 22, 42, 52 Rp 2.680.000
0510
(speaking 42: Listening (Extended) 42 *) additional fee for oral exam
Endorsement) 52: Speaking 52 (speaking)
Rp 1.450.000

Information & 12: Teory 12

0417 Communication 21: Practical Test 21 AY 12, 21, 31 Rp 2.680.000
Technology 31: Practical Test 31

First
Language 12: Reading 12
0500 BS 12, 22 Rp 2.680.000
English 22: Directed Writing & Composition 22

12: Paper 12 (Core)

AY 12, 32 (Core) Rp 2.680.000
Mathematics 22: Paper 22 (Extended)
0580 (Without 32: Paper 32 (Extended)
Coursework) 42: Paper 42 (Extended) BY 22, 42 (Extended) Rp 2.680.000

BY 22, 42, 52 (Extended) Rp 2.680.000

12: Multiple Choice (Core) 12
22: Multiple Choice (Extended) 22 CY 22, 42, 62 (Extended) Rp 2.680.000
32: Theory (Core) 32 FY 12, 32, 52 (Core) Rp 2.680.000
0625 Physics 42: Theory (Extended) 42
52: Practical Test 52 GY 12, 32, 62 (Core) Rp 2.680.000
62: Alternative to Practical 62
*) additional fee for
Rp 1.450.000
practical
12: Paper 12
0452 Accounting AY 12, 22 Rp 2.680.000
22: Paper 22

ID116 - Kalam Kudus Christian School Surakarta Indonesia

AM. Sangaji Street No. 24, Gajahan, Pasar Kliwon, Surakarta, Central Java, Indonesia. Phone +62271666248
email : smp.ip@kalamkudussolo.sch.id
 12: Paper 12
0495 Sociology AY 12, 22 Rp 2.680.000
22: Paper 22
Bahasa 01: Reading and Understanding
0538 Indonesian 02: Reading and Writing 01, 02, 03 Rp 2.680.000
03: Speaking and Responding
AS/ A Level
Code Subject Paper no & Component information Option Fee (IDR) ✓

- - - - Rp 3.000.000

Total amount for the examination fee for all choosen syllabuses include practical/
oral exam/speaking test
Registration Fee per candidate Rp. 1.450.000

Final Stage Late fee (11 Aug to 20 Sept 2020) Rp 1,685,000/syllabus

Total amount for the examination fee

Note:
For detail information about the IGCSE/AS/A Level syllabuses please contact the Centre.

Declaration

▪ I certify that the information given on this form is complete, true and accurate
▪ I understand that I shall be allowed to sit only for the subjects that I entered
▪ I understand that there will be NO transfer or postponement of examination
▪ I understand that there will be NO refund of the fees if I decide to withdraw from the examinations
▪ I acknowledge receipt of Information for candidates & the examination timetable
▪ I understand that I shall not register for Cambridge IGCSE, ASS/A Level examinations/syllabuses with two
examination centres in a particular session

 (please tick ✓ ) For candidates 18 years old and above

Candidate’s Signature: Date:

 (please tick ✓) For candidates below 18 years old

Guardian’s Signature: Date:

Official Use

ID116 - Kalam Kudus Christian School Surakarta Indonesia

AM. Sangaji Street No. 24, Gajahan, Pasar Kliwon, Surakarta, Central Java, Indonesia. Phone +62271666248
email : smp.ip@kalamkudussolo.sch.id