Accuplacer Sign-Up Request - Lake Providence Campus

We will contact you to set up a testing appointment.

Today's Date Today's Date / MM / DD YYYY
Name Name First Last
Student ID # (L Number)
Date of Birth Date of Birth / MM / DD YYYY
Phone Number Phone Number - ### - ### ####
Email Address
Major/Degree of Study
Which Test?

Which Test? Math $15 Reading $10 English $10
Voucher#
I understand that I may NOT use cell phones or any other electronic devices at any time during testing. The consequence of a violation of test security may include the invalidation of test scores.
I am interested in becoming an LPN student, and I understand that successful attempts in taking the Accuplacer must be separated by at least 5 days.