Additional Score Report Request Form
Personal Information
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Mailling Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Test Information
Name of Test/Exam
Date of Test/Exam
-
Month
-
Day
Year
Date
Test Center (if applicable)
Registration/ID Number (if known)
Score Report Delivery
Please select your preferred delivery method for the additional score report
Regular Mail (standard processing time)
Express Courier (additional fees may apply)
Electronic Delivery (if available)
Other
Submit
Should be Empty: