Voucher Form - Frank Phillips College

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Testing Voucher Form

Please ONLY complete the following form if you are NOT planning to test at Frank Phillips College.

Voucher Form

Student Information

Name:(Required)

First Middle Last

Other name(s) that might appear on academic records:

Student Type(Required)

Citizenship:(Required)

U.S. Citizen

International Citizen

Address:(Required)

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

Phone Number:(Required)

Replace +1 with your country’s dialing code (e.g., +44 for UK, +91 for India).

Date of Birth:(Required)

MM slash DD slash YYYY

Voucher Information

IMPORTANT NOTICE: Please read and acknowledge the following statements.(Required)

I have read and understand the following statements.

TSI Scores are valid for 5 years.

Students are responsible for verifying whether they are required to take the TSI Assessment and identifying which subject areas they need to complete.

You must complete your test(s) prior to the voucher expiration date. You can find the voucher's valid date listed under VOUCHER INFORMATION in the email you will receive from ACCUPLACER once the request is complete.

Select Voucher Type(Required)

Virtual Voucher (virtual proctoring that allows students to test remotely using a secure online platform.)

Remote Network Voucher (allows students to take their TSI exam at another ACCUPLACER-approved institution or test center site outside of FPC)

FEES: The standard remote proctoring fee for using Meazure Learning virtual proctoring service is $28. Schedule your test at least 72 hours in advance to avoid additional on-demand fees.   On demand fees: 24 to 72 hours prior = $5 usd;  Less than 24 hours notice: $8 usd.

Remote Site Information

Note: Frank Phillips College (FPC) does not participate in third-party or off-site proctoring services. If you choose to test at a location other than FPC, please be aware that the testing site WILL charge a separate proctoring fee.

State & Country of Remote Site(Required)

State / Province / Region Country

To use a Remote Network Voucher, you must contact the institution where you plan to take the test. Please obtain the following information from them:

Institution Name:(Required)

Site Name:(Required)

City/Town of Remote Site(Required)

City/Town

Payment

Choose the subject area(s) that apply:(Required)

Complete TSI / Full TSI / All Subjects

TSI Math Only

TSI ELAR (for English Language Arts and Reading)

TSI Reading  Only (multiple choice)

TSI Writing Only(for WritePlacer essay)

Complete TSI / Full TSI / All Subjects Fee:

Price:

Individual TSI Fee

Price:

Confirmation:(Required)

I have read and understand the following statements.

Once registration for a subject area is submitted, it cannot be changed. If it is later determined that a section is not required, you will still be obligated to complete it in order to receive your scores. Please verify your testing requirements carefully before registering.

The voucher fee is NON-REFUNDABLE regardless of use.

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Frank Phillips College

1301 W. Roosevelt | Box 5118
Borger, TX 79007
Telephone: (806) 457-4200

FPC Allen Campus

2314 S. Jefferson
Perryton, TX 79070
Telephone: (806) 648-1450

FPC Rahll Campus

2890 FM 281
Dalhart, TX 79022
Telephone: (806) 244-7669

Board Policy Manual

Institutional Resume

Notice of Nondiscrimination

Obligations-Disclosure to Public

Open Records Information

Quality Enhancement Plan (QEP)

Board Of Regents
Human Resources
Mental Health Resources
Student Complaint Form
Title IX/Sexual Misconduct

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