ACCUPLACER EXAM Sign Up

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					                           ACCUPLACER EXAM
                                      SIGN-UP SHEET


The purpose of this exam is to identify the recommended class placement in the areas
of: Math, Writing and Reading for those planning to attend a state, community or
technical college. There is no fee. Students may also take the Accuplacer Exam on the
campus of the post-secondary program.


I would like to sign up (print student’s name):________________________________ for the
Accuplacer Exam.


You may sign up for one or both dates. Please place an “X” next to the date(s) preferred.

ACCUPLACER Test Date:                                   Return Sign-Up Sheet by:

_____ _January 29, 2013                                             January 22, 2013

______March 5, 2013                                                 February 26, 2013

I grant permission for the Minnesota State Academy for the Deaf to administer the
Accuplacer Exam indicated by an “X” above to my student. I understand that if my student
does not show up on the test date indicated on this registration form, it will be the student’s
responsibility to re-register at a later time, or at another test location. If you have any
questions, please contact Paula Detjen , School Counselor at: paula.detjen@msad.state.mn.us
or at 507-384-6637 voice.

Signature (parent/guardian if student is under 18 years of age):

_______________________________________                             date:_________________



                              Please return Sign-Up Sheet to:

                              Paula Detjen, MA, LMFT, LPC
                                     School Counselor
                           Minnesota State Academy for the Deaf
                                 615 Olof Hanson Drive
                                  Faribault, MN 55021

				
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