Test Registration Test Takers Agreement Please select from any available tests. First Name: Last Name: Home Address: Date of Birth: City: State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip: Name of the University you currently attend: People Soft ID: Phone (DAY): Phone (EVENING): Email Address: RETEST: Is this your first time taking an ACTFL assessment in this language? (Select one): YesNo LANGUAGE TO BE TESTED: Arabic Hindi Vietnamese PLEASE INDICATE WHEN YOU ARE AVAILABLE TO TEST: Please provide a RANGE of availability (dates & times) that you and your proctor can do the test. Allow at least 10 business days from the date of your request submission, if you are submitting completed proctor forms with this application. Date 1: Time 1: From To Date 2: Time 2: From To OTHER IMPORTANT TEST INSTRUCTIONS: Once your application has been processed, you and your proctor will be sent separate e-mails with your test date, time and other test instructions. This e-mail will provide a unique ID and PASSWORD to access your test information and status on the LTI Test Candidate Website (www.languagetesting.com/individual). Please retain this important e-mail and website information for your records as you will use this website and secure password to verify the date and time of your test and check the status of your test result. You will also have the option to print your final rating certificate from the website. Please allow UP TO 4 WEEKS from the date of your test to receive your final rating. CONFIRMATION OF TEST DAY, TEST STATUS AND RESULTS: Be sure to arrive at the test site 15 minutes prior to the above test time. Please bring two forms of picture identification with you. For missed appointments or for appointments that a notice for rescheduling is not delivered to LTI with at least 24 hours advance notice, there is a $55 rescheduling fee. In the event you miss your scheduled test appointment, please contact firstname.lastname@example.org to reschedule your appointment. For a test that is cancelled and not rescheduled, there is a $55 cancellation fee that will be deducted from your refund. To cancel an application and receive your refund or to check the status of your refund, please e-mail your request to email@example.com.