Eastern Florida State College CLEP Registration Form __________________________________ Last Name ______________________________ First Name __________________________________ Student ID Number _____________________________________________________ Email address (If you are an active EFSC student, we will use your Titans email account) __________________________________ Mailing Address ______________________________ City ________________ Date of Birth ______________________ Telephone Number _______________________________ Recipient School ______________________ Test Date (3rd Sat of the Month Unless College is closed) _____________ MI _____________________ State & Zip Code _____________________ Time 2:15; 3:15; 4:15; 5:15 Composition seated at 5:15 Check all that apply: □ Request Accommodations □ DSST funded □ Repeating Exam (min 3 mo) Examinations for which you are registering: *Optional essays are available for these examinations. Please check with your school to see if an essay is required. Essay sections for which you are registering: Exam Title(s): __________________________________________ American Government ❏ American Literature* ❏ Analyzing and Interpreting Literature* ❏ Biology ❏ ❏ Calculus Chemistry ❏ College Algebra ❏ ❏ College Composition College Composition Modular* College Mathematics ❏ English Literature* ❏ Financial Accounting ❏ French Language ❏ German Language ❏ History of the United States I: Early Colonization to 18 ❏ History of the United States II: 1865 to the Present ❏ ❏ Human Growth and Development ❏ Humanities ❏ Information Systems ❏ Introduction to Educational Psychology ❏ ❏ Introductory Business Law Introductory Psychology ❏ Introductory Sociology ❏ Natural Sciences ❏ Precalculus ❏ Principles of Macroeconomics ❏ Principles of Management ❏ Principles of Marketing ❏ Principles of Microeconomics ❏ Social Sciences and History ❏ Spanish Language ❏ Western Civilization I: Ancient Near East to 1648 ❏ Western Civilization II: 1648 to the Present ❏ ________________________________________ Signature ___________ Color of Hair __________ Color of Eyes __________ Sex ___________________________________________ CLEP Test Ticket Number (purchased at My Account) _________________________________________ EFSC Service Fee Payment Record ___________________________________________________________________________________________ Eastern Florida State College - Melbourne Campus Assessment Center- Building 10, room 218 3865 North Wickham Road, Melbourne FL 32935 Phone: 321-433-5876; 321-433-5585 • • Registration Deadline is the Thursday before the CLEP administration. On the day of your CLEP Exam, you must bring with you: Your CLEP Test Ticket purchased with credit card directly at the CLEP website. Set up My Account, register and pay for a CLEP Exam, and purchase student material, go to https://clepportal.collegeboard.org/myaccount Test vouchers are good for 6 months. Required identification: Candidate must present a valid government-issued photo ID with signature, such as a driver’s license, passport, or state ID. Name on ID must match the name on the CLEP test ticket. Minors under the age of 18 (or others with CollegeBoard approval) may present an executed Alternate ID form. The Student ID Form can be downloaded from the Exam Day Info page of the CLEP website: http://clep.collegeboard.org/exam-day-info . You can also contact CLEP Services at (800) 257-9558, (212) 237-1331, or clep@info.collegeboard.org for information on obtaining the College Board ID Form. Social security cards, Credit Cards, Student ID or Business ID cards are not acceptable forms of Identification. • • DANTES-funded military personnel must provide a military ID. DO NOT bring food or drink, books, papers, watches, or any electronic devices.