INCIDENT REPORT FORM
Incidents must be reported via this form within 24 hours of the affected test. The CELBAN Centre defines incidents as occurrences that involve significant deviation from CELBAN's examination administration standards and procedures. The CELBAN Centre does not accept responsibility for incidents that occur as a result of the examinee’s technical equipment, or the examinee not being prepared to take the test.
Upon receipt of an incident report, the CELBAN Centre will investigate the circumstances surrounding the administration of the test. If it is determined that the incident substantially affected the established procedures and could potentially impact test results, you will be contacted to arrange a retake of all or part of your test. If it is determined that the incident did not affect the procedures or fairness of your test, your performance will be scored following the usual procedures, and you will receive your results within 15 business days.
To inform the CELBAN Centre of an incident you believe may affect your test results:
1.
Complete the form below, providing as much detail as necessary.
2.
Expect an automated email confirming your submission.
3.
Allow up to 15 business days to receive a response.
.
SPEAKING TEST DATE
yyyy-mm-dd
Date and time
Calendar
COMPUTER BASED TEST (CBT) DATE
yyyy-mm-dd
Date and time
Calendar
PLEASE SPECIFY THE TEST APPOINTMENT THE INCIDENT REPORT SHOULD BE APPLIED TO:
SPEAKING TEST
COMPUTER BASED TEST (CBT)
BOTH THE SPEAKING TEST AND CBT
EXAMINEE INFORMATION
CELBAN ID (if available):
Given (First) Name:
Family (Last) Name:
Date of Birth:
yyyy-mm-dd
Date and time
Calendar
Email:
Confirm Email:
EXAMINEE ADDRESS AND PHONE NUMBER
Street Number and Name:
City:
Province/Territory/State:
Country:
Postal Code/Zip Code:
Phone Number:
Please describe the incident you experienced in as much detail as possible:
I have read the above information about how the CELBAN Centre will manage my incident report.