AREA EXAMINATION REQUEST FORM 

Basic Information:

Name:  

Student #:  

Address:  City:  

State:   Zip Code:  

Contact Information:

Work Number:  
 
Home Number:  
 
Mobile Number:  

Email:  

Subject Area To Be Taken:

 

Request Time:

         

PLEASE READ CAREFULLY

Note: Please submit a transcript to the Department of Education & Psychology as well as submitting your application online. You may fax your transcript to 601-877-6211 or email to hwilliams@alcorn.edu.  Please check with the Department to make sure that we have received your application and transcript. You may contact us at 601-877-6200. The way to inform you on if you passed or failed the exam will be by letter through the mail. Results should be in within three to four weeks.

Before submitting this request form, please review the information above to make sure it is correct.  

 

 

 
 
1000 ASU DRIVE   |   ALCORN STATE MISSISSIPPI 39096-7500   |   PHONE: 601.877.6100