Authorization

I hereby authorize the TOEIC representative in __________ to confirm for the Korea TOEIC Committee / YBM/Si-sa my TOEIC scores per the information below. On my request, the Korea TOEIC Committee may relay the scores to a third party.

First name:_______________________

Family name: _____________________

Date of birth: _____________________

Test site: _________________________

Test date: _________________________

Test application (admission) number: _____________________

Address on test application form: ________________________________________________

Telephone number on test application form: ___________________

l	TOEIC Score

Listening: ____________

Reading: _____________

Total: ________________

Please confirm the above scores and report confirmation to:

Korea TOEIC Committee / YBM/Si-sa

#56-15 Jongno 2 ga, Jongno-gu, Seoul, Korea 110-122

E-mail: check@toeic.co.kr

Telephone number: 82+2 2280-7294  /  Fax number: 82+2 2280-7369

Signature of candidate, as it appears on passport: ___________________

Date of Authorization: ________________

Unless renewed, this Authorization will expire 90 days after the date above written, at which point this document will be destroyed.

(예시문)

Authorization

I hereby authorize the TOEIC representative in Japan to confirm for the Korea TOEIC Committee / YBM/Si-sa my TOEIC scores per the information below. On my request, the Korea TOEIC Committee may relay the scores to a third party.

First name:    Gil Dong

Family name: Hong

Date of birth:  07/25/1980

Test site:      Tokyo, Japan

Test date:     03 / 23 / 2008

Test application (admission) number:  050000-4

Address on test application form:

56-15 Jongno 2 ga, Jongno-gu, Seoul, Korea 110-122

(시험 접수 시 기재했던 주소를 기재하셔야 합니다.)

Telephone number on test application form: 2279-0509

l	TOEIC Score

Listening: 355

Reading: 295

Total:    650

Please confirm the above scores and report confirmation to:

(이곳에 반드시 자필 서명하시기 바랍니다. 자필서명이 없을 경우에는 성적조회가 되질 않습니다.)

Korea TOEIC Committee / YBM/Si-sa

#56-15 Jongno 2 ga, Jongno-gu, Seoul, Korea 110-122

E-mail: check@toeic.co.kr

Telephone number: 82+2 2280-7294  /  Fax number: 82+2 2280-7369

Signature of candidate, as it appears on passport: ___________________

Date of Authorization: 04 / 12 / 2008 (작성일자를 기입하시면 됩니다)

Unless renewed, this Authorization will expire 90 days after the date above written, at which point this document will be destroyed.