Complete the form below to sign up for the Accuplacer Placement Exam Please complete the form below Name * First Name Last Name Middle Inital Email * Date of Birth * Mobile Phone # * (###) ### #### Please acknowledge the following * I understand that the cost per exam is 20.00 I understand that payment must be made to WTC prior to date of my scheduled exam Signature Line * Please enter your name in the space below. Thank you! Someone from LBCI will contact you in 48 hours to schedule your Accuplacer exam.