Download Anmeldeformular_A1_13012014_EN

Julu Lu 628
Tel.: 021 – 62 89 77 62
www.goethe-slz.sh.cn
"Goethe-Zertifikat A1: Start Deutsch 1" Examination Application FormDate of
Examination: 13.01.2014
The Goethe-Zertifikat A1: Start Deutsch 1 requires very basic language skills. The examination corresponds to
level one (A1) on the six-level scale of competence laid down in the Common European Framework of Reference
for Languages. In order to achieve this level of competence, a minimum of 200 45-minute teaching units is
recommended, depending on your previous knowledge and learning requirements.
For the Goethe-Zertifikat A1: Start Deutsch 1 an age of 16 years or over is recommended.
Examination structure: "Goethe-Zertifikat A1: Start Deutsch 1" consists of the following parts:
1. Listening (about 20 minutes)
2. Reading (25 minutes)
3. Writing (20 minutes)
4. Oral test in group (15 minutes).
Exam date: 13.01.2014, 9:30 - 10:35 Written Exam; 14:00 Oral test
Attention: Please, arrive at the exam venue 45 minutes before the examination starts, i.e. no later than 8:45.
Location: Shanghai Jing’an District College, Building 1, Jiaozhou Lu 601
Registration Deadline:31.12.2013
Terms of Participation:
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You can come in person to our main office to apply for the examination, or send us the registration form by
fax or mail. Along with the signed registration form you will need to hand in a copy of your passport or
identity card, two recent photos (two inches, color) as well as the registration fee (which can be paid directly
in the language office, or by bank wire);
On exam day, please bring as well your exam confirmation letter which you have earlier received via email.
If you pass the exam and expect us to forward your results to the German embassy or a consulate in China
for the purpose of the results being used within the process of your visa application (Ehegattennachzug),
please sign the respective authorization paragraph below on this registration form.
In addition to the examiners, only exam candidates are allowed in the examination room during the exam.
Bags or mobile phones are not allowed in the examination room. For the time of the written exam, your
belongings will be safely locked in a separate room.
Prior to the exam we will check your ID or passport. Please bring your original identification, since copies or
other documents will not be accepted. As part of the identity verification process, a photo of you will be taken
before the exam starts. Please, have your passport or ID ready for inspection for the entirety of the exam.
In the written part of the examination, you will receive the test sheets, an answer sheet and draft paper.
Please make sure to transfer all your answers onto the answer sheet, because only answers marked on that
sheet will be graded. Participants cheating, using unauthorized resources or making these available to others
will be excluded from the exam. In the event that an exam participant should be excluded from the exam for
one of these reasons, as a rule, the earliest date upon which the exam may be repeated shall fall three
months after the date of exclusion from the exam.
Please use a ballpoint or a fountain pen to write on the answer sheet. Please do not use a pencil on the
answer sheet.
There are no restrictions regarding the number of repetitions of this exam. It can, however, be repeated only
as a whole.
On the website of Goethe-Institute http://www.goethe.de/lrn/prj/pba/bes/sd1/mat/enindex.htm you can find
Set of model exams for practice
Exam guidelines
Terms and conditions for exam administration
Information for exam candidates with special needs
Julu Lu 628
Tel.: 021 – 62 89 77 62
www.goethe-slz.sh.cn
For your information
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About one week prior to the exam participants will receive an electronic exam confirmation in your email that contains
specific details regarding time and place of the exam. Please print this confirmation and bring it on exam day along with
your passport or ID-card. (original documents only)
All prepaid exam charges will be fully reimbursed at a handling fee of 80 RMB if participants withdraw one week before the
exam or earlier. Invoices already issued must be returned in this case. Participants withdrawing less than one week before
the exam will not be reimbursed. One week before the exam or earlier, participants can also shift their original exam
appointment to the following exam period at Goethe-Jinchuang (usually two months later). If participants decide to shift
their exam to a later time, subsequent cancellations or further time suspensions will not be granted.
Results and grades of „Start Deutsch 1“ and „Start Deutsch 2” exams can be obtained at the end of the same exam day. B1,
B2 and C1 exams take a processing time of 5 work days before results and grades can be released upon phone inquiry.
A1 as well as A2 certificates will be issued within 5 work days after the exam, B1, B2 and C1 certificates take ten work days.
Certificates can be personally obtained during office hours in Julu Lu 628, providing adequate identification, such as
passport or ID. Third parties collecting certificates on behalf of the examinee need to produce a copy of that person’s
passport or ID in order to receive the certificate.
Through a courier service, certificates can also be delivered to examinees’ homes at the recipients’ expenses. The
appropriate forms will be provided on exam day or at the Goethe-Jinchuang reception desk in Julu Lu 628. A1 and A2
certificates will be mailed two weeks after the exam. B1, B2 and C1 certificates will be sent off three weeks after the exam.
If this option is selected, recipients are requested to note down the courier code for their own files in order to contact the
courier company directly for questions regarding the delivery.
Appeals against the results of the exam or against the administration of the exam are regulated by paragraphs 19, 21 and 22
of the exam guidelines of the Goethe-Institut. Further questions regarding appeals can be directly addressed to
Goethe-Jinchuang via email or phone: [email protected] Tel.: 021- 32220316
Please, fill out the exam registration form correctly and deliver a copy of your valid passport or ID card as well as two color
passport photos of a high quality. If examination fees have been wired to our bank account, please, bring a copy of the
transfer voucher as well. These documents need to be submitted to our registration desk in person, by mail or email ahead of
the time for applications.
Address: No. 628 Julu Road, 200040 Shanghai
Email: [email protected]
Examinees’ information
Last Name
First Name
Gender
Date of Birth
Place of Birth
Nationality
ID Number
Address/Post
Phone
E-mail
How long did you learn
German?
Preferred
date
examination
of
I have read the information given above.
Date:
Signature:
Julu Lu 628
Tel.: 021 – 62 89 77 62
www.goethe-slz.sh.cn
DECLARATION OF CONSENT
Last Name, First Name:____________________________________________
1. DECLARATION OF CONSENT REGARDING DATA PRIVACY
Within the context of visa applications regarding foreign spouses relocating to Germany (Ehegattennachzug), the Goethe certificate A1
(or any higher certificate) is recognized by German embassies and consulates as proof of basic German language skills that are
required by respective visa regulations. In order to check the authenticity of handed in certificates, the responsible German
representation abroad can receive names, exam results and certificate numbers of examinees who took the exam intending to use the
certificate within their visa application and who passed the exam.
By signing this declaration of consent, examinees agree to their personal data being forwarded to the responsible German
representation abroad. With immediate effect, examinees can officially retract from their declaration of consent at any time.
The declaration of consent is optional. In case of not signing or revoking it, examinees need to proof their certificate’s authenticity to the
visa issuing authorities in other adequate ways if there is skepticism regarding the document’s genuineness, which, in this case, cannot
be verified by the Goethe-Intitut’s data.
To this effect, the examinee declares the following:
“I hereby grant a permit to the Goethe-Jinchuang language learning center in Shanghai to forward my personal data (i.e. my name, my
exam results and my certificate number), in case I pass the exam, to the German embassy / the German General Consulate in
____________, to be used for inspection within the context of my visa application process.”
Signature:
Date:
2. Declaration of Consent
On executing my signature below, I hereby authorize the Exam Center to transmit and store my personal data (“Data”), which I provided
under the terms of my registration, in the central customer database housed in the headquarters of the Goethe Institute e.V. in Munich,
Germany (“GI-HQ”) and there to combine this Data with any other Data previously provided and stored there.
Furthermore, I consent to the use of my Data by the Exam Center and the Goethe Institute for purposes exceeding those outlined in the
executed agreement, namely for market research, advertising and any marketing associated with the range of services offered by the
Exam Center and the Goethe Institute, in particular to send me relevant requests or advertisements (“Information”), such as, but not
limited to, information about new course offerings at the Exam Center or the Goethe Institute. Such Information will be sent to me in the
mail using the postal address I provided - and if I stipulate - may also be transmitted to me via telephone, fax, e-mail and/or text
message (SMS) using the Data I have provided.
Data concerning the exams I have taken may also be transmitted to the Goethe Institute for storage and use in the central examination
archives (for a maximum period of 10 years) and used for verification purposes and to issue replacement certificates, as required. To
the extent that the Data relates to exams, which entitle my foreign spouse to subsequently immigrate to Germany, I hereby authorize the
Goethe Institute to confirm, at the request of the German authorities, the authenticity of a certificate I have submitted to a government
agency.
Neither the Goethe Institute nor the Exam Center will use my Data for any additional purposes not otherwise specified in this consent
agreement. In addition, neither the Goethe Institute nor the Exam Center will not provide any Data to a third party, unless there is a
reasonable suspicion of fraud with regard to the Data.
I have been informed that I may revoke my authorization for my Data’s use for market research, advertising and marketing purposes at
any time.
________________________________
Place, Date, Signature
Yes, I would also like to receive information via e-mail/ SMS/ telephone/ fax
________________________________
Place, Date, Signature
________________________________________________________________________________________________
Right of Revocation
You may exercise your above-mentioned right to opt out right now or at anytime later in what follows:
o I herewith immediately revoke my authorization for my Data’s use for advertising and marketing purposes.
________________________________
Place, Date, Signature