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Accuplacer Registration Request Form
Thank you for your interest in completing the Accuplacer exam.
YOU ARE HERE --> Step 1: Complete request form and request testing site
UPON COMPLETION of this form:
Step 2:
Pay assessment fee via emailed link
Step 3:
Schedule your test using information sent in payment confirmation email
Step 4:
Pay the $25 site proctoring fee and take the assessment
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* Indicates required question
Email
*
Your email
I intend to test at the following site
*
Choose
WESD
Chemeketa Salem
Chemeketa Yamhill
Date of Birth
*
MM
/
DD
/
YYYY
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
ACCUPLACER assessment(s) you intend to complete
*
Next Gen Reading
Next Gen Writing
Next Gen Math: Arithmetic
Required
Confirmation and acknowledgement.
Please read the statement below.
By checking "I understand", you confirm the following:
I understand that the confirmation page contains the payment link
AND that I must pay for all assessments online using the link provided
AND the cost is $3 per assessment.
*
I understand
Required
I will receive an email response to this form with all of my responses,
AND once the WESD receives confirmation of payment, I will receive information via email to schedule my assessment(s) at the site I have requested.
AND it may take up to three (3) business days to receive scheduling information.
*
I understand
Required
All sites require a $25 proctoring fee
AND the proctor fee must be paid at the testing site when I take my test
AND the form of payment must be cash or check.
*
I understand
Required
A copy of your responses will be emailed to the address you provided.
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