Iowa Central Placement Test Score Request Form


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  1. There is a $25.00 processing/proctoring fee to send placement test scores to another institution. Scores will not be sent until payment has been received. Once the Placement Test Score Request form is received, you will be contacted by the Testing Services Coordinator to complete the payment process.
  2. The highest scores will be sent to the requested destination (indicated on the placement test score request form).
  3. Some institutions consider test scores to be valid only for a specific duration. Please check with your future institution prior to requesting your scores to confirm procedures.
  4. To fill out the placement test score request, enter your information below.

* indicates a required field

* First Name: A value is required.
* Last Name: A value is required.
  Former Name:
* SSN or Student ID: A value is required.
* Birth Date: A value is required.Invalid format. Must be in MM/DD/YYYY format.
* Phone: A value is required.Invalid format.A value is required.
* Address: A value is required.
* City: A value is required.
* State: Please select an item.
* Zip: A value is required.
  Country:
Send Placement Scores:
* Please select an item.
   College/Business Name
* Name/Attention: A value is required.
* Address: A value is required.
* City: A value is required.
* State: A value is required.
* Zip Code: A value is required.
   Country:
* E-mail to: A value is required.Invalid format.
* Confirm E-mail: A value is required.The values don't match.
Special Instructions
 
You will be contacted in 1-2 business days in order to complete the payment process.

By clicking the submit button, I give Iowa Central Community College permission to release my test scores to the institution(s) listed above.