LSAT Test Date Change Form
This form must be received by the test date change deadline indicated at LSAC.org; forms received after the deadline will be returned
unprocessed. You may only request a change to another test date within the current testing year (June 2017–February 2018). However, those
who register for February may request to change to the June 2018 exam only.
Last Name (Family or Surname) First Name (Given)
Middle Initial
Date of Birth
MM/DD/YYYY
Last Four Digits of Social Security or Social Insurance Number Phone Number
Street Address or PO Box; include apartment number, if applicable
City State/Province US Zip/Postal Code Country
L
Note: Please check if new address. LSAC Account Number
Previous Test Date: Saturday Sabbath Observers
0
0
Sept. 16, 2017 0
0
Feb. 10, 2018 0 Sept. 18, 2017 0 Dec. 4, 2017 0 Feb. 12, 2018
Dec. 2, 2017 Feb. 11, 2018
(Asia, AU/NZ)
Check the one test date for which you were registered.
Change To: Saturday Sabbath Observers
0
0
0
Dec. 2, 2017 0
0
0
June 11, 2018 0 Sept. 18, 2017 0 Dec. 4, 2017 0 Feb. 12, 2018
Feb. 10, 2018 June 23, 2018
(Europe, Middle East, Africa)
Feb. 11, 2018 (Asia, AU/NZ) June 24, 2018 (Asia, AU/NZ)
First-choice test center number and location Second-choice test center number and location
Test Date Change Fee: $100 ($95 CDN) Amount Enclosed $
Enclose check or money order in US dollars made payable to LSAC
OR charge: 0 VISA
0 MasterCard 0 DISCOVER q American Express
VISA/MasterCard/DISCOVER/American Express account number Exp. Date
(MM/YYYY)
Name on Credit Card
Credit Card Billing Address:
Street Address or PO Box; include apartment number, if applicable
City State/Province US Zip/Postal Code Country
Include a check or money order made payable to LSAC or enter a VISA, MasterCard, DISCOVER, or American Express account number and the
card’s expiration date. Indicate the last four digits of your Social Security or Social Insurance number on your check or money order.
Do not send cash or foreign currency.
Mail this completed form to: LSAC, Test Date Change Request, PO Box 2000-T, Newtown, PA 18940-0995, USA; fax to 215.968.1277;or
scan and email to LSACinfo@LSAC.org.
Important: Read the following statement. Sign your name and enter the date. Law School Admission Council (LSAC) will not process this form
if this statement has been modified or altered in any way, is incomplete, or not signed.
I authorize LSAC to process the test date change requested above. I certify that I have read LSAC’s policies at LSAC.org and am aware that
my test date change request will be processed in accordance with published policies. If paying by credit card, I warrant that I am authorized
to make charges to the account I have identified and authorize LSAC to make the appropriate charges.
Signature Date
© 2017 by Law School Admission Council, Inc. All rights reserved. LSAC and LSAT are registered marks of Law School Admission Council, Inc.
6/2017
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signature
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