College-Level Examination Program
®
Transcript Request Form
Use this form to request a transcript if you did not indicate a score recipient institution at the time of testing or if you need to send your scores to
more than one score recipient. Indicate which exam(s) you want to appear on your transcript. Please note that CLEP
®
keeps scores on file for 20
years. Once your request form has been received, please allow two business days for internal processing and up to 10 business days for mailing.
✯
Note: Military personnel (in active duty or retired) should call 877-471-9860 (toll free) or 443-751-4316 to request a military transcript,
or visit clep.collegeboard.org/military to download a transcript request form. There is a fee of $30 for each military transcript.
PLEASE PROVIDE ALL THE INFORMATION REQUESTED ON THIS FORM. PLEASE PRINT.
Name at the time of testing (last name, first name, middle initial)
Current name, if different from above (last name, first name, middle initial)
Last 4 digits of SS#
Current address: number, street and apartment
Address: number, street and apartment at time of testing
City State/Province ZIP Country
Daytime telephone number (include area code) Email address
/ /
This is a mandatory field. If you fail to include your date of birth, the transcript request form will not be processed.
Date of birth (month/day/year)
❏
American Government
❏ American Literature
❏ Analyzing and Interpreting Literature
❏ Biology
❏ Calculus
❏ Chemistry
❏ College Algebra
❏ College Composition
❏ College Composition Modular
❏ College Mathematics
❏ English Literature
❏ Financial Accounting
❏ French Language
❏ German Language
❏ History of the United States I: Early Colonization
to 1877
❏ History of the United States II: 1865 to the Present
❏ Human Growth and Development
❏ Humanities
❏ Information Systems
❏ Introduction to Educational Psychology
❏ Introductory Business Law
❏ Introductory Psychology
❏ Introductory Sociology
❏ Natural Sciences
❏ Precalculus
❏ Principles of Macroeconomics
❏ Principles of Management
❏ Principles of Marketing
❏ Principles of Microeconomics
❏ Social Sciences and History
❏ Spanish Language
❏ Western Civilization I: Ancient Near East to 1648
❏ Western Civilization II: 1648 to the Present
❏ Other
❏ English Composition (Retired)
❏ English Composition w/Essay (Retired)
❏ Freshman College Composition (Retired)
❏ Send only exam scores of 50 or above (for computer-based exams). ❏ Send all scores. ❏ Official candidate copy only
CLEP TRANSCRIPT RECIPIENT
*IMPORTANT! PLEASE READ: Visit collegeboard.org/clepcolleges to search for your institution. Please enter mailing information according to
what is listed in the CLEP Colleges listing. Transcripts cannot be mailed to alternate addresses of institutions available in the CLEP Colleges listing.
Score Recipient College code #*
Person at the institution to whom transcript should be sent (if known)
Address of institution where CLEP transcript should be sent
PAYMENT INFORMATION
There is a fee of $20 for each transcript.
_____________ Visa, MasterCard, American Express, Discover, JCB
_____________ Debit card (Visa or MasterCard)
Credit or debit card number: _________________________________________________ Expiration Date: ________________
I authorize CLEP to release my scores to the institution designated above.
Signature Date
I
f you are paying by credit or debit card, call 800-257-9558. You may also fax this form to 610-628-3726.
© 2016 The College Board. College Board, CLEP, and College-Level Examination Program are registered trademarks of the College Board. All other products
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and services may be trademarks of their respective owners. Visit the College Board on the web: collegeboard.org.
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