Fill - Free fillable Score-Release-Form ASU Testing Center Placement Score Release Form PDF form

Placement Score Release Form

Testing Center

Instructions:

1. Type in your information and print the completed form.

2. Signature of student and copy of photo id is required.

3. Mail, fax, email, or bring (with your photo id) to the

ASU West Campus Testing Center.

Test scores cannot be released without signed authorization from the student.

ASU West Campus Testing Center Email: asutesting@asurams.edu

2400 Gillionville Rd., Bldg. G-101 Fax: 229-500-4948

Albany, GA 31707 Phone: 229-500-2921

Office Use Only:

Faxed _______________________

Emailed _______________________

Mailed _______________________

Picked Up______________________

Date of Request

LAST Name

FIRST Name

Student ID #

or go to next box

OR Last 5 #s of

Social Security #

Date of Birth

Daytime Phone #

Email Address

Send scores to the following institution or person by: ☐ EMAIL ☐ FAX ☐ MAIL ☐ RELEASE TO ME

Person’s Name and/or Institution to receive scores:

Office at Institution (Admissions, Testing, etc.):

Email Address:

Fax Number:

Mailing Address:

1. Fill out form. 2. Print. 3. Then add your signature below. There is no fee to send scores.

I authorize the ASU Testing Center to release my placement test scores to the person or

institution listed above.

Signature Required: ____________________________________________________________________

Fill Online, Printable, Fillable, Blank Score-Release-Form ASU Testing Center Placement Score Release Form Form