Test Score Release Authorization

The Test Score Release Authorization grants permission for UA Little Rock to either: 1. send scores from Accuplacer exams taken at UA Little Rock to other entities, or 2. access scores on the Accuplacer portal and for those Accuplacer scores to be included in UA Little Rock records.

Name

First Last

Student Number (if applicable)

Date of Birth

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Country Phone Number

I want to:

Testing Location

Name of Recipient (individual, agency, or institution)

First Last

Address of Recipient

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email of Recipient

Photo ID(Required)

You must upload your photo ID to complete your request.

Max. file size: 24 MB.

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Test Score Release Authorization