TSIA Cross Institutional Report Request
Testing Center-Kilgore Campus1100 Broadway Kilgore, TX 75662903.983.8215 phonetesting@kilgore.edu
Students wishing to provide access to their TSI Assessment test results to an institution where the student did
not test must provide permission to the receiving institution to access those results. Also, a student’s name
must exactly match the name on the student’s driver license or other official government-issued
document.
Students testing at other institutions in Texas may request their scores be retrieved through the College Board
Cross Institutional Reporting system. In order to collect a student’s test scores, the following information must
be provided:
Please print the following information:
Name of institution to receive scores:______Kilgore College_______________________________________
Student First Name:___________________________ Student Last Name:____________________________
Date of Birth: (mm/dd/yyyy)____________________ Student ID:(optional)___________________________
Student email address:_________________________ Student phone________________________________
Institution administering exam: __________________City ______________ State_____ Zip_____
I, _____________________________authorize the Kilgore College Testing Center located in Kilgore, Texas
Student’s Name
on the main campus to obtain my TSIA test scores through the TSI Cross Institutional reporting process.
Student Signature__________________________________________________ Date____________________
**Notice:
Students will be required to show a valid, recognizable photo ID in order to obtain the testing record. As a
reminder, test scores will not be faxed or emailed to any institution or individual requesting the record.
Third Party Certification
I, _____________________________authorize the Kilgore College Testing Center located in Kilgore, Texas
Student’s Name
to release my TSI test scores to__________________________.
Student Signature__________________________________________________ Date__________________
College officials only
Signature of Individual retrieving test record_____________________________Date__________________
Signature of Individual receiving test record_____________________________Date__________________
Updated 1/2021
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