Test Center Reimbursement

IMPORTANT: You must have used a Modern States CLEP voucher and provide a copy of your CLEP exam score to request test center reimbursement.

Please note, it takes approximately 8-10 weeks to process a reimbursement request.
Name*
First Last
Country of residence*
- I live in the United States
- I live in Canada
- I live in another country
Address*
Street Address Address Line 2 City State ZIP Code
Address*
Street Address Address Line 2 City Province Postal Code
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone
Exam(s) Taken*
Hold the CTRL key (COMMAND on a Mac) and click the exams to select them. Please select all of the exams you are requesting reimbursement for. Click any item again to deselect it. Remember to keep the CTRL/COMMAND key pressed.
Exam Taken*
Second attempt to obtain the required score on this exam?
- Yes, this is my second attempt
SUNY Student / Prospective SUNY Student?
- I am a SUNY Student/I am a New York State Resident who wants to attend a SUNY College or University
Purdue Fast Start Program?
- I am a participant in or want to participate in the Purdue Fast Start Program
Test Center Fee ($)*
Attached Receipt(s)*
Drop files here or

Accepted file types: jpg, jpeg, gif, png, bmp, tiff, pdf.
Exam Score
Candidate Score Report
Accepted file types: jpg, jpeg, gif, png, bmp, tiff, pdf.
Voucher Number*
Please enter the voucher number provided by Modern States for this exam
Request ID

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