Fillable How to Complete the Registration Form (Southern University at Shreveport)

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How to Complete the Registration Form (Southern University at Shreveport)

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Before You Begin
Examadministrationschedules,registrationdates,
and deadlines are set by individual test centers.
Contact your test center directly for this information
before filling out this registration form. Some institutions
use their own forms or have online registration proce-
dures. Others will accept this form. Check with your test
center to find out the deadline for submitting registra-
tion information.
Items12and13—Test Dates
Contact your test center for available test dates. Enter
your first and second test date choices (month, day, and
year). A second date is needed in case there are any
scheduling problems.
If you plan to take more than one test, you must submit
separate fee payments for each exam.
Item15—Students with Disabilities
Check this box if you require testing accommodations.
Be sure to contact your test center well in advance of the
test date to make the necessary arrangements and to find
out its deadline for submitting documentation. (See page
3, “Accommodations for Students with Disabilities.”)
Item17—Examinations
Check the box next to the title of each examination you
wish to take. If your school requires you to write an
optional essay, check the box and enter the title of the
exam(s) for which you will also take the essay section.
Exam descriptions are on pages 4–6.
Test centers’ policies vary as to how many examinations you may
take in one day. Check with the test center where you plan to test.
Item18—RepeatingExaminations
If you are repeating any of the examinations you checked
in Item 17, check this box.
Any examination may be repeated six months or more
after you last took it, but inquire about your college’s
regulations before registering for retesting. Scores on
testsrepeatedearlierthansixmonthswillbe
canceled and test fees forfeited.
Item19—Fees
CLEP Exam Fees: The fee for each CLEP exam is $70.
Certain exams have an optional essay. If your institution
requires an optional essay, you must pay an additional $10
fee to your test center. CLEP exams and optional essays
are free to all eligible military personnel and civilian
employees (with proper military ID). Test fees must be
paid by valid credit card (preferred method of payment)
or a check or money order made payable to the College-
Level Examination Program. Checks made payable to any
other payee will not be accepted, and CLEP cannot be
responsibleforcashsentthroughthemail.Yourcheckor
money order may be dated no more than three months
earlier than the test date. There is a $15 surcharge for a
returned check. A separate payment is required for each
CLEP exam.
TestCenterAdministrationFees: Most test centers
charge a nonrefundable administration fee, directly
payable to the institution. The College Board recommends
a $15 administration fee; however, each test center
establishes its own policy and may charge a
different amount. DANTES-funded military candidates
are required to pay the test center administration fee.
Contact the test center directly to inquire about forms of
payment for the administration and optional essay fees.
How to Complete the Registration Form
Submit your Registration Form directly to your test center.
1. First Name (Please print.) 2. M.I. 3. Last Name
4. Birth Date 5. Sex ❏ M ❏ F
6. Color of Hair 7. Color of Eyes
8. Daytime Telephone 9. E-mail Address
10. Street Address 11. City, State, Zip, Country
12. First Choice Test Date (mm/dd/yyyy) 13. Second Choice Test Date (mm/dd/yyyy)
14. Test Center Name
See your counselor or the CLEP
®
Web site for a list of test centers.
15. Students with documented disabilities: Check here ❏ if you need testing accommodations.
Be sure to contact your test center to make the necessary arrangements before the test date. Each test center sets its own deadlines for submission of documentation and
approval of accommodations.
16. Are you a DANTES-funded military examinee? ❏ Yes ❏ No
17. Examinations for which you are registering:
❏ American Government
❏ American Literature*
❏ Analyzing and Interpreting Literature*
❏ Biology
❏ Calculus
❏ Chemistry
❏ College Algebra
❏ College Mathematics
❏ English Composition
❏ English Composition with Essay
❏ English Literature*
❏ Financial Accounting
❏ French Language
❏ Freshman College Composition*
❏ 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 and Computer
Applications
❏ 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
*Optional essays are available for these examinations. Please check with your school to see if the essay is required.
Essay sections for which you are registering: Exam Title(s)
18. Repeating Exams ❏ Check here if you are repeating any of these exams. Remember, you must wait six months before repeating an examination.
19. Fees: The fee for each exam is $70. If you are taking an exam with an optional essay, there is an additional $10 fee payable to your test center. You must pay for the exam
on the day of the exam by valid credit card (preferred method of payment) or a check or money order payable to the College-Level Examination Program. Do not combine
fees for multiple tests even if they are to be taken on the same day. CLEP exams and optional essays are free to eligible military personnel, and eligible civilian
employees with proper military ID. See
page 3
for eligibility details. Your test center may also require a separate, nonrefundable administration fee; contact the test center
about payment.
Paying by:
❏ Credit Card (Visa, MasterCard, American Express, Discover, JCB) ❏ Check/money order Check #: Checkholder name:
20. Signature
REGISTRATIONFORM
Note:Some test centers use their own forms. Check with your test center about the form it requires.
070062095
Return form and payment to test center, not CLEP.
/ETS Marquis Hall Test Coordinator
Email: mhall@susla.edu Fax: 318-670-6457
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How to Complete the Registration Form (Southern University at Shreveport)

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Completed 17 September 2020

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