ACCUPLACER
Pre-Registration
Name____________________________________________SS#_____________________________________
Date of
Birth______________________________________Phone___________________________________
Address__________________________________________________________________________________
City, State, Zip____________________________________________________________________________
Test
Date_________________________________
Time__________________________________________
Alternate test date and Time if
first choice is full__________________________________
Are
you currently enrolled at SPC?____________
Do
you have an application on file in the Admissions Office?_______________
YOU MUST HAVE AN APPLICATION ON FILE BEFORE YOU WILL BE ALLOWED TO TEST
Cost
The proper testing fee MUST accompany pre-registration at least three days
prior to the exam. No refunds will be granted. If a testing date is missed the
testing fee is forfeited and must be paid again.
Accuplacer
Registration and Testing Fee
$30.00 Money Order,
cash, or check payable
to SPC
$20.00 for 1 or 2
parts
We will mail your receipt back to you at the address
provided. You must bring your receipt to the testing site.
You must bring two forms of identification
and your receipt to the testing site: One must be a photo ID. The other ID must be something with your
social security number on it.
Send Pre-registration form and testing fee to:
South Plains College
Juli Wood, Testing Coordinator
1401 College Avenue, Box Z
Levelland, TX 79336
For your
registration to be complete, you must sign the registration form, sign the
Rules and Conditions form (located at the bottom of this form), and include the
test fee. Registration material without these items included will not be
honored.
I
certify that I have read this application and have answered all questions
correctly and to the best of my knowledge.
Student Signature Date
PLEASE SEE RULES
AND CONDITIONS ON PAGE 2