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Da Requestforscoretransferform

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Assessment Center
deanza.edu/admissions/placement/
De Anza College Assessment Center 21250 Stevens Creek Blvd. Cupertino, CA 95014
Room: RSS143 / Phone: (408) 864-8717 / Email: daassessment@fhda.edu
REQUEST FOR ASSESSMENT SCORE TRANSFER
P
er your request to transfer your assessment score(s) to De Anza, please submit this completed form to the De Anza
College Assessment Center at daassessment@deanza.edu
. This process can take up to five (5) business days.
Student Name:
De Anza Student ID#
Email:
Phone:
Date:
Instructions:
• Attach a copy of your official Accuplacer or CELSA scores. Your document should include:
o Your full name, exam date, the institution’s name, and your test scores.
• If requesting the transfer of scores from Foothill, you do not need to attach your score results.
De Anza Assessment Validity Rules Apply:
• ACCUPLACER/CELSA scores must be less any five (5) years old by today’s date.
ACCUPLACER English Test Date: __________________________
Reading Comprehension Score: ________________________ or See My Foothill Results
Sentence Skill Score: _________________________________ or See My Foothill Results
Note: Students must make an appointment to take the De Anza English Essay.
ACCUPLACER Math Test Date: ____________________________
Arithmetic Score: ________________________________ or See My Foothill Results
Elementary Algebra Score: ________________________ or See My Foothill Results
College Level Math Score: _________________________ or See My Foothill Results
Note: Students can attempt the De Anza Calculus Readiness Test to test into MATH 1A: Calculus
C
ELSA ESL Test Date: _______________________________ Score: _________________
Note: Students must make an appointment
to take the De Anza ESL Essay.
Foothill College Chemistry 1A Exam Date:___________________ Score: See My Foothill Results
By signing below, I acknowledge and accept that transferring Assessment scores from another institution
counts as my initial placement at De Anza College and all testing policies apply.
Signature: _______________________________________________ Date: ___________
* Your results will be uploaded to your My Portal account within 5 business days. www.myportal.fhda.edu
*
FOR OFFICE USE ONLY – Do not complete
Date Received:
Assessment Placement at De Anza:
Comments:
Processed by:
Approved / Denied
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Da Requestforscoretransferform

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Completed 29 November 2019

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