SAMPLE ANSWER SHEET

ITP

786529
1. NAME: Print your name as you entered it in the first 21 boxes on your admission form.
Using one box for each letter, first print your family name (surname), then your first (given) 3. DATE OF BIRTH 4. NATIVE 5. NATIVE
name, and then your middle name. Leave one box blank between names. Then, below 2. STUDENT NUMBER (if assigned)
COUNTRY LANGUAGE
Start here MO. DAY YEAR
each box, use a No. 2 (H.B.) pencil and fill in the circle containing the same letter. CODE CODE

A A A A A A A A A A A A A A A A A A A A A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

B B B B B B B B B B B B B B B B B B B B B 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

C C C C C C C C C C C C C C C C C C C C C 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

109019-102832 • TF815E250 • Printed in U.S.A.

D D D D D D D D D D D D D D D D D D D D D 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

E E E E E E E E E E E E E E E E E E E E E 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4

F F F F F F F F F F F F F F F F F F F F F 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5

G G G G G G G G G G G G G G G G G G G G G 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6

Q3792/1-2
H H H H H H H H H H H H H H H H H H H H H 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7

I I I I I I I I I I I I I I I I I I I I I 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8

J J J J J J J J J J J J J J J J J J J J J 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9

K K K K K K K K K K K K K K K K K K K K K 6. SEX 7. 8. PLACE OF TESTING

LEVEL 2
L L L L L L L L L L L L L L L L L L L L L MALE (PRE-TOEFL)
M M M M M M M M M M M M M M M M M M M M M
NAME OF SCHOOL/INSTITUTION
LEVEL 1
N N N N N N N N N N N N N N N N N N N N N FEMALE (TOEFL-ITP)
O O O O O O O O O O O O O O O O O O O O O 10. SIGNATURE AND DATE: Please copy the following
P P P P P P P P P P P P P P P P P P P P P
statement in the space provided below; use
9. BACKGROUND QUESTIONNAIRE handwriting.
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q RESPONSES
“ I hereby affirm that I am the person whose
R R R R R R R R R R R R R R R R R R R R R 1 2 3 4 name is given on this answer sheet.”
S S S S S S S S S S S S S S S S S S S S S A A A A
Also sign your name on the line provided, and enter today’s
T T T T T T T T T T T T T T T T T T T T T B B B B date (in numbers).
U U U U U U U U U U U U U U U U U U U U U C C C C
DATE:
V V V V V V V V V V V V V V V V V V V V V D D D D MO. DAY YEAR
W W W W W W W W W W W W W W W W W W W W W E E E

X X X X X X X X X X X X X X X X X X X X X F F F

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y G G

Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z

SIGNED:
(WRITE YOUR NAME AS IF SIGNING A BUSINESS LETTER.)

TEST BOOK NUMBER TEST FORM Be sure to fill in completely the circle that EXAMPLE
corresponds to your answer choice.
Completely erase errors or stray marks. CORRECT INCORRECT INCORRECT INCORRECT INCORRECT
You may find more answer spaces than A B C D A B C D A B C D A B C D A B C D
you need. If so, leave them blank.

SECTION 1 SECTION 2 SECTION 3

1 A B C D 21 A B C D 41 A B C D 1 A B C D 21 A B C D 1 A B C D 21 A B C D 41 A B C D
2 A B C D 22 A B C D 42 A B C D 2 A B C D 22 A B C D 2 A B C D 22 A B C D 42 A B C D
3 A B C D 23 A B C D 43 A B C D 3 A B C D 23 A B C D 3 A B C D 23 A B C D 43 A B C D
4 A B C D 24 A B C D 44 A B C D 4 A B C D 24 A B C D 4 A B C D 24 A B C D 44 A B C D
TCS

5 A B C D 25 A B C D 45 A B C D 5 A B C D 25 A B C D 5 A B C D 25 A B C D 45 A B C D
6 A B C D 26 A B C D 46 A B C D 6 A B C D 26 A B C D 6 A B C D 26 A B C D 46 A B C D Copyright © 2015 by Educational Testing Service. All rights reserved.
7 A B C D 27 A B C D 47 A B C D 7 A B C D 27 A B C D 7 A B C D 27 A B C D 47 A B C D
8 A B C D 28 A B C D 48 A B C D 8 A B C D 28 A B C D 8 A B C D 28 A B C D 48 A B C D
9 A B C D 29 A B C D 49 A B C D 9 A B C D 29 A B C D 9 A B C D 29 A B C D 49 A B C D
3CS

10 A B C D 30 A B C D 50 A B C D 10 A B C D 30 A B C D 10 A B C D 30 A B C D 50 A B C D
3R

11 A B C D 31 A B C D 11 A B C D 31 A B C D 11 A B C D 31 A B C D
12 A B C D 32 A B C D 12 A B C D 32 A B C D 12 A B C D 32 A B C D
13 A B C D 33 A B C D 13 A B C D 33 A B C D 13 A B C D 33 A B C D
14 A B C D 34 A B C D 14 A B C D 34 A B C D 14 A B C D 34 A B C D
2CS

15 A B C D 35 A B C D 15 A B C D 35 A B C D 15 A B C D 35 A B C D
2R

16 A B C D 36 A B C D 16 A B C D 36 A B C D 16 A B C D 36 A B C D
17 A B C D 37 A B C D 17 A B C D 37 A B C D 17 A B C D 37 A B C D
18 A B C D 38 A B C D 18 A B C D 38 A B C D 18 A B C D 38 A B C D
19 A B C D 39 A B C D 19 A B C D 39 A B C D 19 A B C D 39 A B C D
1CS

20 A B C D 40 A B C D 20 A B C D 40 A B C D 20 A B C D 40 A B C D
1R

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