Release of ACCUPLACER Scores

Please fill out this form to request a copy of your ACCUPLACER scores.

If you need multiple copies of your scores, please submit a new form for each request.

Student Information

Name*

First Name

Last Name

Date of Birth*

Student ID*

Nine digits

Preferred Email*

Confirm Preferred Email *

Preferred Phone

(e.g. 555-555-5555)

I agree that I am the person listed above, and I authorize Fox Valley Technical College to release my scores to the address listed above.

Send To Information

Send to Name/Department*

Send to Address*

Address Line 1

Address Line 2

City

State

ZIP Code