DEPARTMENT OF COUNSELING & STUDENT AFFAIRS
COMPREHENSIVE EXAMINATION
REGISTRATION FORM
Exam Date: Saturday, September 6, 2014, 9:00 a.m.
Sharadin Art Building, Room 120
Date:
___________________ Student ID #: __________________________
Name:
___________________________________________________________
Address:
___________________________________________________________
___________________________________________________________
KU E-Mail: _____________________________ Phone ________________________
PAYMENT: Cashier’s check or money order for $50 made out to:
CCE
(Center for Credentialing & Education, Inc.)
Please note:

You must be enrolled in an internship class during the academic year in which you take the
comprehensive exam.

This is the only day and time the exam will be available for Kutztown University students.
Return completed form & payment to;
Dr. Margaret Herrick, Old Main A Wing, Rm. 418
by Friday, August 8, 2014
STUDENTS WHO MISS THIS DEADLINE WILL HAVE TO CONTACT THE CCE TO
LOCATE ANOTHER TESTING SITE.
--- For office use only --_____ Payment Received __________________ Date
Revised 5/13