Testing Services
Enrollment Form
For School Districts or Educational Service Centers
Ordering Credit by Exams in Quantity
Find information
online:
www.ttuisd.ttu.edu
Questions? Call:
800.MY.COURSE
(800.692.6877)
Mail to:
TTUISD
Box 42191
Lubbock, Texas 79409-2191
806.742.7101
Locally
Fax to:
806.742.7212
INSTRUCTIONS
This form has been created for use by school districts and educational service centers when ordering CBEs in quantity. All exams ordered
on this form will be sent to the address listed below. Please see that students get review material in time to study for their
exams. Use this form to indicate the total number of exams you need for each subject area and total costs.
Reminder: students may only take a CBE twice. If you are ordering for multiple campuses and would like the tests to be bundled
together by campus, please use a separate Exam Form for each campus and complete the information at the top of each one.
No refunds will be granted for CBEs.
Test Date ________________________ School District or ESC Official’s Signature___________________________________________________
COST INFORMATION
School districts ordering in quantity will receive the new bulk discount rate.
CBEs are now $23 each with no shipping charge for standard shipping.
Expedited overnight delivery will be available for an extra fee.
SHIPPING INFORMATION
Information must be completed by school district official; please print legibly.
School District Official’s Name___________________________________________Title_______________________________________________
Educational Service Center or School District Name____________________________________________________________________________
Campus Street Address____________________________________________________________________________________________________
City________________________________________________________________ State______________________Zip_______________________
Telephone (
)________________________________________________________________________ County__________________________
Contact Person’s Name & Email_____________________________________________________________________________________________
BILLING INFORMATION (IF DIFFERENT THAN SHIPPING)
Information must be completed by school district official; please print legibly.
School District Official’s Name___________________________________________Title_______________________________________________
Educational Service Center or School District Name____________________________________________________________________________
Street Address____________________________________________________________________________________________________________
City________________________________________________________________ State______________________Zip_______________________
Telephone (
)________________________________________________________________________ County__________________________
E-mail___________________________________________________________________________________________________________________
PAYMENT INFORMATION
q C heck – SCHOOL OR DISTRICT CHECKS ONLY (make checks payable to Texas Tech University) CK#____________________
q Money Order # (payable to Texas Tech University) # _________________________ q P.O. #________________________________
q Credit Card: q MasterCard q VISA q Discover q American Express
Card # _______________________________________________________ Cardholder’s Name _______________________________________
Expiration Date _______________________________________________ Signature _______________________________________________
***NO CHECKS OR CREDIT CARDS FROM PARENTS ACCEPTED ON BULK ORDERS***
OCT2015
Testing Services
Summary Form
For School Districts or Educational Service Centers
Ordering Credit by Exams in Quantity
Find information
online:
www.ttuisd.ttu.edu
Questions? Call:
800.MY.COURSE
(800.692.6877)
806.742.7101
Locally
Mail to:
TTUISD
Box 42191
Lubbock, Texas 79409-2191
Fax to:
806.742.7212
INSTRUCTIONS
If you are an Educational Service Center ordering for multiple school districts, use one form per district. If you are a school district ordering
for multiple campuses, use one form per campus. If you don’t need your exams sorted by districts or campuses, you may use only one form.
q
Educational Service
Center Name:___________________________________________________________________________ q
School District
Name:_________________________________________________________________________________
County District
Number:_______________________________________________________________________________
Campus (if applicable) Name:_________________________________________________________________________________
q
CREDIT BY EXAMS
Name of Credit by Examination
Number Needed
Cost
Example: English 9A
50
$1150
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
TOTAL FOR EXAMS
$_________________________________
OCT2015