ACCUPLACER Reservation Form

ACCUPLACER Reservation Form

Bay Minette, Fairhope and Gulf Shores
Student Name

First NameLast Name
Coastal Student Number
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Phone Number

Area CodePhone Number
Coastal Alabama Student Email
example@example.com
IF YOU WISH TO TEST VIRTUALLY, PLEASE EMAIL THERESA.MCCLELLAND@COASTALALABAMA.EDU TO SCHEDULE YOUR TEST. OTHERWISE, PLEASE SELECT A TEST DATE/TIME OPTION BELOW
Please select location, date and time you wish to take the ACCUPLACER
Should be Empty: