Student Testing Services

Accuplacer Distance Testing Administration Form


Incomplete or Incorrect Requests Will Not be Processed.

If we can't read your handwriting, we can't process your request!

PLEASE WRITE LEGIBLY!!!

 

Student Name:            __________________________________

Student Phone Number:                             ____________________

Student SLCC ID Number: S00                 ___________________ _

Student E-mail Address:                                 ___________________________

Name of Institution willing to proctor test:                        ____             ____        

Name and contact information of person at institution:

Name of Contact Person:                                     _________________________

E-mail of Contact Person:                                       ________________________

Phone Number:                                                                      __________________

Fax Number:                                                                _______________________

Date you have scheduled with your proctor for test administration:______________________ (Your access will expire the following Sunday at 7:00 pm.)

NOTE: After you have completed your test, your scores WILL NOT be posted until we receive the completed “Accuplacer Distance Proctor Agreement” from your proctor.

***Form must be received at least 2 business days in advance of proposed testing date.***

 

IMPORTANT

***Form must be received at least 2 business days in advance of proposed testing date.***

Weber State University students MUST test at Weber State University

SEND FORM TO

Print form and fax  to:

Fax:  801-957-4750

Or copy and paste into email:

testingservices@slcc.edu