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ACT Education Home

ACT Test Center 2009–2010 Request Form

In order to request information about your institution becoming a test center, you must be a faculty or staff member from the named institution.

are required fields

Institution Details

1. Institution Name
2. High School Code (If applicable)
3. Mailing Address
4.  
5. City
6. State Select... AK Alaska AL Alabama AR Arkansas AZ Arizona CA California CO Colorado CT Connecticut DC District of Columbia DE Delaware FL Florida GA Georgia HI Hawaii IA Iowa ID Idaho IL Illinois IN Indiana KS Kansas KY Kentucky LA Louisiana MA Massachusetts MD Maryland ME Maine MI Michigan MN Minnesota MO Missouri MS Mississippi MT Montana NC North Carolina ND North Dakota NE Nebraska NH New Hampshire NJ New Jersey NM New Mexico NV Nevada NY New York OH Ohio OK Oklahoma OR Oregon PA Pennsylvania RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VA Virginia VT Vermont WA Washington WI Wisconsin WV West Virginia WY Wyoming
7. ZIP Code

Contact Details

1. First Name
2. Last Name
3. Title
4. Phone
5. Fax
6. Email

For each test date you are requesting, enter the maximum number of students your site can accommodate in the "Anticipated Volume" column.

Test Dates

Date(s) Requested	Anticipated Volume
September 12, 2009
October 24, 2009
December 12, 2009
February 6, 2010
April 10, 2010
June 12, 2010