Placement Test Registration Form

Placement Test and Orientation Registration Form
You must be an admitted student to use this form.
Full Name

First NameLast Name
Phone Number

Area CodePhone Number
Cellphone Number

Area CodePhone Number
E-mail
Choose a preferred Placement Test Date:
NOTE: if a specific test date is not available as a selection, that date is full
Date & Time (Select one)
Fees to be paid at least 24 hours prior to your placement test date:

$125 New Student Fees + $100 Advance Tuition Deposit = Total Due $225

Please send payment to:
UW-Manitowoc Student Services Office
705 Viebahn Street
Manitowoc, WI 54220
Choose your preferred Orientation/Registration date:

You must complete the placement test prior to your Orientation session.
NOTE: if a specific test date is not available as a selection, that date is full
Date & Time (Select One)
Select One Date
Please submit the form once. You will receive a copy in your email to confirm it was processed.
We encourage you to sign up for the earliest date possible. Please submit this online form at least one week in advance. Don't forget to mark the date on your calendar!

If you will not be attending UW-Manitowoc this semester or if you have any questions, please e-mail Student Services or call (920) 683-4707.

Your privacy is important to us. All information submitted to us will be used by our Student Services Office for required contact purposes only. It will not be shared with or sold to any third parties
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Placement Test and Orientation Registration Form