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):
__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
__Educational Psychology __Macroeconomics
__Educational Psychology __Management, Principles of
**Optional essays not available.
FEES – PLEASE READ CAREFULLY:
$107.00 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 $77.00 exam fee payable to CLEP (eff. 7/1/10)
Number of CLEP exams ________ x $107.00 = $ _______________ TOTAL
***IF PAYING THE $107.00 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 CLEP FEES 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 Antoine
SMU Testing Center
P.O. Box 750195
Dallas, Texas 75275
BRING $77.00 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 Antoine
214.768.2269