Name_______________________________________ Date of Birth________________
Address_________________________________________________________________
City, State and Zip________________________________________________________
Daytime Phone #_______________________Social Security
#_____________________
Email address:__________________________________________________________
The MAT is given every Tuesday at 9:00 a.m. by appointment. Please call 214-768-2269 for availability BEFORE submitting this form.
Preferred Test Date:_______________________________________________________
Have you taken the MAT before? _____No _____Yes: ______________(date)
FEES -- PLEASE READ CAREFULLY:
The NON-REFUNDABLE MAT test fee is $85.00, payable to SMU by money order, Visa, MasterCard or Discover. CHECKS ARE NOT ACCEPTED.
***IF PAYING BY CREDIT CARD:
Credit card type (please check) _______MasterCard ________Visa _________Discover
Card Number __________________________________________Exp. Date _________
Name as it appears on credit card_____________________________________________
________________________________________________________________________
Signature
Date
Complete this form and fax to 214-768-4522.
***IF PAYING BY MONEY ORDER:
Money order payable to SMU enclosed (please check) _________
Complete this form and mail with money order to:
Lori Krone
Counseling and Testing Center
Southern Methodist University
P.O. Box 750195
Dallas, Texas 75275-0195
***
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
lkrone@smu.edu
214-768-2269