CLEP Registration Form
Name____________________________________________Date of Birth________________
Address_______________________________________________________________
City, State and Zip______________________________________________________
Daytime Phone # _____________________ Social Security #___________________
Email address:_________________________________________________________
CLEP tests are given Mondays and Fridays at 9:00 a.m. and 3:00 p.m. by appointment with advanced registration and payment using this form. Please call 214.768.2269 for availability BEFORE submitting this form.
Preferred Test Day/Time (circle one):
Monday 9 AM Monday 3 PM Friday 9 AM Friday 3 PM
Preferred Test Date: ____________________________________________________
GENERAL exams for which you are registering (please check):
| __English Composition |
__English Composition with Essay |
| __College Mathematics |
__Humanities |
| __Natural Sciences |
__Social Sciences and History |
SUBJECT exams for which you are registering (please check):
| __Algebra, College | __English Lit | __Marketing, Principles of |
| __American Govt. | __Financial Accting | __Microeconomics |
| __American Lit | __French Language |
__Precalculus |
| __Analyzing/Interp Lit | __German Language | __Psychology, Intro |
| __Biology | __History of U.S. I |
__Sociology, Intro |
| __Business Law, Intro | __History of U.S. II |
__Spanish Language |
| __Calculus | __Human Growth/Dev | __Western Civilization I |
| __Chemistry | __Info Systems & Computers | __Western Civilization II |
| __Composition, Freshman | __Macroeconomics | |
| __Educational Psychology |
__Management, Principles of |
FEES – PLEASE READ CAREFULLY:
$102.00 PER EXAM. This is a split fee. Students must pay a NON-REFUNDABLE $30.00 registration fee to SMU WITH THIS REGISTRATION FORM, and a $72.00 exam fee payable to CLEP (eff. 7/1/09)
Number of CLEP exams ________ x $102.00 = $ _______________ TOTAL
***IF PAYING THE $102 FEE(S) BY CREDIT CARD, COMPLETE THE FOLLOWING:
Credit Card Type (check one):_______MasterCard _________Visa _________Discover
Card Number ______________________________________ Exp Date____________
Name on Credit Card (please print)___________________________________________
Signature of Cardholder________________________________Date________________
FAX your completed form to 214.768.4522 or mail it to the address below.
***IF PAYING THE $102 FEE(S) BY MONEY ORDER, MONEY ORDERS MUST BE ISSUED AND SUBMITTED SEPARATELY:
MAIL this completed form with $30.00 money order(s) for each exam PAYABLE TO SMU for NON-REFUNDABLE registration fee to:
Lori Krone
SMU Testing Center
P.O. Box 750195
Dallas, Texas 75275
BRING $72.00 money order(s) PAYABLE TO CLEP for exam fee on exam day.
You will receive a call from the SMU Testing Center upon our receipt of this form by fax or mail to confirm your desired test date, followed by a written confirmation with specific instructions about parking, our location on campus, and what to bring on your test date.
Thank you for testing with us,
Lori Krone
214.768.2269