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ACCUPLACER Registration Form – SPC REESE CENTER

 

You must contact the Testing and Learning Center for test availability before sending in this form.

 

Please Type Information – Print Form and Mail to Address Below:

 

South Plains College – Reese Center

Testing and Learning Center

Attn:  Dr. Deborrah Caddell

819 Gilbert Drive

Lubbock, TX 79416

 

(If paying by credit card, you may fax form to (806) 897-3081 or mail form with credit card information)

 

Name:
Social Security Number:
Address:
City:
State:
Zip Code:
Telephone Number:
Date of Birth:
Email Address:
Preferred Test Date:
Time:
Alternate Test Date:
Alternate Test Time:

Which section(s) are you taking?     Reading        Elementary Algebra

                                                        Arithmetic  (administered to students who are retesting for the LVN

                                                                                                            and Surgical Technology Programs at the Reese Center only)

                                                        English (multiple choice English and essay)

 

 Please check below if you are taking the test for:

Dual Credit   Vocational Nursing Program  Surgical Technology Program   Cosmetology Program

EMT Basic  EMT Intermediate or Paramedic

 

 How would you like your admission ticket sent to you?

Email:
Fax:

Mail: (if you select this option, you must provide a self-addressed stamped envelope in order for us to mail you an admission ticket for the test)

 

 

Name:

 

 

  Payment method (you MUST include payment for your registration to be complete):

Check   Money Order    Mastercard or Visa

 

Credit Card Number:
Credit Card Expiration Date:

 

Name of Card Holder:

 

For your registration to be complete, you must:

1.    Include a copy of a current picture ID (i.e.

       Driver's License)

2.    Include a copy of a document containing your

       Social Security Number (i.e. a signed        

        Social Security Card)

3.    Include the test fee

4.    Sign this registration form below stating that

        you agree to bring the admission ticket,

        picture ID, and a document containing your

        Social Security Number on the day of the

        exam, and that you agree to the Rules and

        Conditions below.

 

YOU MUST BRING WITH YOU ON TEST DAY:

• Admission Ticket
• One picture ID, such as a Drivers License
• One ID with your Social Security Number, i.e., a signed Social Security Card 

 

_______________________________           ______________________________

Student Signature                                                       Date

 

Please scroll down for Testing Rules and Conditions

 

Keep the following for your records (Do not mail)

SOUTH PLAINS COLLEGE

AGREEMENT TO COMPLY WITH TESTING RULES

Whether registering in person or by submitting a registration form by mail or fax I agree to comply with the Rules of Test Participation and with any rules communicated to me at each test administration.  Failure to sign the Rules of Test Participation will result in my not being allowed to test.    

Rules of Test Participation

COMPLIANCE: I understand that if I fail to comply with the Rules of Test Participation my test scores will be voided, no refund will be issued, no portion of the testing fee will be applied toward the cost of any future testing fees, and I will not be permitted to register for current or future test administrations at South Plains College.  Legal proceedings and actions may be pursued as well as any other remedies that South Plains College may deem appropriate.

 

ELECTRONIC DEVICE POLICY:  I understand that electronic devices (see page 4) are not allowed in the testing room.  I understand that these devices will be collected before I take a test at South Plains College.  By signing below I agree to turn off all electronic devices.  Leaving a device on vibrate or silent is not acceptable.  If my electronic device is activated during the test session, I understand that my test scores may be canceled and this will affect future ability to test.  I do have the option to take electronic devices to my vehicle before the test starts.  It is my responsibility to collect all items that I leave in the testing room.

 

TEST FEES:  I understand that all fees paid for testing are non-transferable and non-refundable.  If I am late for a test or if I miss a test date, I will have to pay the fee again to test at another date.

 

ADMISSION TICKET:  I understand that I will not be allowed to test if I do not have an admission ticket for the specific test date. 

 

IDENTIFICATION:  I understand that I will not be admitted into the testing room if I do not have one official current picture ID (i.e. Driver’s License, passport, military ID, student ID) and a Social Security ID (i.e. Social Security card).  Dual Credit students may use a high school yearbook as a picture ID or a letter from a high school administrator with the student’s picture attached.    

 

RETEST:  I understand that I must wait at least two weeks before retesting on the ACCUPLACER test.

 

PURPOSE OF TESTING: I understand that the test I will take will be used to assist in placing me in the appropriate courses, determining the need for developmental coursework, and/or to meet certain program admittance requirements.  I certify that I am taking the test to meet one or more of the purposes stated above and for no other reason.

 

LATE ARRIVAL: I understand that if I arrive fifteen minutes after a test administration was scheduled to begin (time indicated on the admission ticket), I will be refused admission, in which case I will be considered absent and I will receive no refund or credit of any kind.

 

TEST ADMINISTRATION: I authorize the test administrators to serve as my agents in main­taining a secure test administration. I agree to follow all reasonable instructions given to me either orally or in writing at or during the test administration, including, but not limited to, instructions to relocate me during the test session. I agree not to leave the test site until I have completed the test and have been dismissed by a test administrator. I also agree not to communicate with other examinees or any unauthorized persons in any way during the test admin­istration nor to engage in any other form of misconduct. I agree not to engage in behavior that would disrupt or unfairly affect the performance of myself or other examinees. I agree to provide the identification specified and to cooperate with testing personnel. If I fail to comply with these provisions, I will be dismissed from the test center and my score(s) will be voided without refund or credit of any kind, and other actions may be taken as deemed appropriate by South Plains College. 

 

TEST PROPERTY:  I understand that the test and all test materials were developed at great cost and are required to be kept confidential and secure from disclosure in order to fairly and effectively perform the functions for which they were designed. I have not received nor reviewed any test materials prior to taking the test and no test materials will be available for me to review after the test. I am not permitted to take and nor will I not take any test materials or handwritten or printed notes reflecting or recording anything about the test materials into the testing room nor will I disassemble, copy, or reproduce the test materials in whole or in part, by hand or with the use of any electronic or other type of device of any nature.

TEST MATERIALS: I understand that I will not be permitted to bring to or use during the test: notes, Microsoft Word or Microsoft Excel, cellular phones, electronic information or communication devices, calculators, scratch paper (not provided by testing personnel), or any other aid not approved in advance by the test administrators of South Plains College. Throughout the test session, I will have nothing on my desk except for the items approved by the test administrators of South Plains College.  I understand that if I do use unauthorized aids, including but not limited to the list above, my test score(s) will be voided and it will affect future ability to test at South Plains College.  I understand that if, despite my foregoing agreements indicated above, test administrators have a reasonable suspicion that I have or may have in my possession any test materials, notes, and/or unauthorized aids, I will immediately turn over any such test materials, notes, and/or unauthorized aids in my possession to the test administrators at any time upon their request. If I should fail or refuse to do so or if the test administrators believe in good faith that I have not turned over all such test materials, notes, and/or unauthorized aids in my possession, the test administrators will conduct a reasonable review of my personal possessions for such test materials, notes, and/or unauthorized aids and will remove and retain any such test materials, notes, and/or unauthorized aids that I may have for as long as may be required.  Test administra­tors are not responsible for returning unauthorized aids or other prohibited material confiscated by them or otherwise turned over by me. In the event of a possible breach of test security, I agree to cooperate with testing personnel and I hereby consent to any such reasonable review before my dismissal from the test center. Moreover, I hereby waive any claim that I might otherwise have based upon any such review. If I fail to comply with these conditions, my score(s) will be voided without refund or credit of any kind; and any other actions may be taken as deemed appropriate by South Plains College.

 

NONDISCLOSURE OF TEST MATERIALS: I agree that I will not disclose the test materials or any part of them (including the form, subject matter, substance, and wording of any test question or any answer) to anyone for a period of ten (10) years from the date of the test administration to which such test materials pertain. I understand and agree that if I should violate this agreement of nondisclosure, I may be liable in damages for the costs (including redevelopment costs) incurred as a result of any breach of this agreement, and I may also be subject to other legal and equitable remedies (including injunctive relief) for any such breach.

           

TEST SESSION:  After admission to the test site, I may not leave the test site for any reason until I have been officially dismissed and all of my test materials have been collected by a test administrator.  When time is called at the end of the test session, I understand that I must stop work immediately or my score(s) will be voided. Once I have completed the test or at the end of the test session, my test materials will be collected and I will be dismissed. I understand that I must collect personal items surrendered before I am dismissed from the testing room.  Once dismissed, I must leave the test center and I will not be readmitted.

 

TEST SCORE REPORTING AND SCORE CANCELLATION BY EXAMINEE: I under­stand that my test score(s) will be reported to me; to the test center where I take the test; and to any other institution, entity, or person authorized or required by law to receive this information. Other Texas institutions and/or state agencies may also receive my score(s) if I sign a Test Score Release Form.  I understand that any information provided as part of registration may be used to report scores or to contact me regarding test- or program-related issues. My score report will be sent even if I leave the testing room before I finish the test. If I do not want my score(s) reported, I understand that I must complete a Score Cancellation Form at the test center on the day of the test. Score cancellation requests submitted after I leave the test center will not be honored. If I cancel my test score(s), I will receive no refund or credit of any kind, and my score(s) will not be reported to me or any Texas institution.

 

 

 

RIGHT TO VOID EXAMINEE SCORE(S): I understand that South Plains College reserves the right to void my test score(s) if I fail to comply with the rules and requirements set forth in the Rules of Test Participation, including rules communicated to me, orally and/or in writing, at the test administration.  Other actions may also be taken as deemed appropriate by South Plains College. I understand that, because of laws protecting confidentiality and privacy, only I can make inquiries about the status of my scores.

 

RIGHTS AND OBLIGATIONS REGARDING TEST ADMINISTRATION: I understand and agree that liability for test administration activities, including, but not limited to, the adequacy or accuracy of test materials and equipment, the adequacy or accuracy of the registration and administration processes or conditions, the adequacy of test site facilities, the adequacy or accuracy of scoring, the adequacy or accuracy of score reports, the adequacy or accuracy of information provided to me in connection with the test, and the adequacy of protection of examinee information will be limited to score correction or test retake at no additional fee. I waive any and all rights to all other claims, specifically including but not limited to claims for negligence arising out of any acts or omissions of South Plains College (including the employees, agents, contractors, or professional advisors).

 

 

  TEST CENTER RULES

When I register for a test at South Plains College, I agree to comply with all the rules set forth in this document and those rules communicated to me at each test administration for which I am registered. Violation of test center rules, including the possession or use of prohibited materials, may result in the voiding of my scores.

During testing, only pencils, erasers, and scratch paper provided by SPC testing personnel will be allowed on my desk unless I am verbally instructed otherwise by SPC testing personnel. 

The following are prohibited at the test center:

	Smoking and the use of all tobacco products
	Visitors, including relatives, children, and friends
	Weapons of any kind

 

PROHIBITED MATERIALS

I WILL NOT bring any unauthorized aids or prohibited materials, listed below, with me to the test center. If I do bring any of these materials, I will be required to leave them in an area designated by SPC testing personnel. 

	Cell phones. Possession or use of cell phones is strictly prohibited in the testing facility and may result in the voiding of your scores.
	Electronic devices and media, such as PDAs, pagers, computers, audiotapes, CDs, photographic or recording devices, removable storage devices, calculator watches, clocks or watches with alarms, spellcheckers, etc.
	Calculators, unless verbally instructed otherwise by SPC testing personnel.
	Handwritten or printed materials, such as dictionaries, notebooks, scratch paper, textbooks, notes, etc.
	Packages and totes of any kind, such as backpacks, briefcases, etc.
	Food and drink, unless previously approved in writing by SPC testing personnel—for students with documented disabilities
	Unauthorized aids, such as slide rules, rulers, translation aids, highlighters, etc.