Revised 10/5/16 \\Gryphon\TC$\Website\Test Score Verification.docx
P.O. Box 929 Yuma, AZ 85366 Phone: 928-344-7641
Test Score Verification
Complete the information below. All fields are required. The estimated processing time is three
business days. Please email or fax this form to testing@azwestern.edu or (928) 344-7712.
Student Information
First Name: Last Name:
AWC Student ID #: Date of Birth:
Email: Phone number:
Please send a copy of my score report to:
Name of School/Institution:
Point of Contact Name:
Title/Position:
Phone number: Fax number:
Email Address:
Authorization to release my scores:
_______________________________________________ _______________________
Signature Date
Office use only:
Name/Title: Date:
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