Request to Transfer ATB Test Scores Form I authorize the transfer of my ACCUPLACER Individual Score Report from the institution that administered my ATB tests (Sending Institution) to the Receiving Institution listed below. (*) Required Field Student Name*
Date when ATB tests were taken*
Student Signature* Date* A representative of either the Sending or the Receiving Institution must fill out the information below. Institution where ATB tests were taken (Sending Institution) Sending Institution Name*
Erie Community College- North Campus
Contact Name* Diane McLaughlin
Contact Phone Number* 716-270-4693 or 716-270-5114 Contact Email Address* mclaughlin@ecc.edu Notes:
Institution to send ATB test scores to (Receiving Institution) Receiving Institution Name* Contact Name*
Contact Phone Number* Contact Email Address*
Address or Fax # to send scores* Notes:
Processing of Form:
For security reasons, the form and score report cannot be emailed; they must be sent
either by postal mail or by fax.
Send to Receiving Institution with student’s ACCUPLACER Individual Score Report. Send to the College Board ACCUPLACER Program with student’s Individual Score
Report within 72 hours.
Retain original copy at Sending Institution.
ACCUPLACER Policies and Procedures for Administering Ability to Benefit (ATB) Tests
© 2019 College Board.
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