Test Score Release Form

Test Score Release Form
Full Name*

First NameLast Name
Student @ID, Comet ID, or Date of Birth*
Email Address*
example@example.com
Phone Number
Please enter a valid phone number.
Method to Send Scores*

EmailFaxPostal Service
School/Institute Name*
School Department or Contact*
Email Address*
example@example.com
Fax Number*
Please enter a valid phone number.
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What scores are you requesting to be released?*

Placement TestNursing Entrance ExamOther
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Which campus did you take the test on?

Flagstaff Lone TreeFlagstaff Fourth StreetPage
Should be Empty: