California State University

English Placement Test (EPT) and Entry Level Mathematics (ELM)

Test Registration Form
Student Information – Please Print Legibly

First Name

Last Name
(It is best to use your legal first and last name instead of nick names)

Mailing Address

City

State Zip Code

Telephone Number

E-mail Address

Last 4 digits of your social security number

Date of Birth

Test Information

Registration for (please chose only one)

… Both the English Placement Test and Entry Level Mathematics

… The English Placement Test Only

… The Entry Level Mathematics Test Only

Test Date

Agreement

I have read and understand the program procedures and conditions as stated in the
Essential Information Pamphlet.

Signature
 Instructions for completing the registration form
This form must be completed so an admission ticket for the test or tests you select can be mailed to
you. Please provide the information requested on the other side of this form after reading the following
instructions carefully.

Student Information
First and Last Name - Enter your first and last names in the space provided. It is best to use your legal
first and last name instead of nick names. Please print legibly.

Mailing Address, City, State and Zip Code – Print your mailing address, city, state and zip code in the
spaces provided.

Telephone Number – enter your telephone number in the space provided.

E-mail Address – Enter your email address in the space provided. Please print legibly.

Last 4 digits of your social security number – Enter the last 4 digits of your social security number.

Date of Birth – Enter your date of birth in the space provided.

Test Information
Registration – Indicate which test or tests you are registering for by marking the boxes to the left of the
description. Fill in only ONE box.

Test Date – Print the test date for which you are registering. Make sure to include the month, date and
year.

Agreement
Signature – Sign the registration form in the designated space. (The form must be signed by the person
registering to take the test or tests.)

You may take the EPT and/or ELM at any CSU campus. Send your registration form directly to the
campus where you wish to take the test(s). Addresses are located on the 2nd and 3rd pages of the
“Essential Information about the EPT and ELM” pamphlet or online at www.ets.org/csu. During your
testing session you will have the opportunity to indicate the campus or campuses (up to 4 of them) to
which you want your scores sent.

IF YOU HAVE QUESTIONS CONERNING THIS REGISTRATION FORM, PLEASE CALL THE TEST OFFICE AT THE
CAMPUS WHERE YOU PLAN TO TAKE THE TEST. THE TEST OFFICE TELEPHONE NUMBERS ARE LOCATED IN THE
PAMPHLET ENTITLED “ESSENTIAL INFORMATION ABOUT THE EPT AND ELM” OR ONLINE AT
www.ets.org/csu.

An admission ticket will be sent to you one or two weeks before the test date. On the day of the test
you must bring your social security number and a driver’s license, student I.D. , or other official
identification with your picture and signature. If you have no ID with a picture, your high school can
prepare an ID document for you on its official stationary. This document should contain a brief physical
description of you. You must sign the document in the presence of your principal or school counselor,
who must also sign it. You may be asked to sign the document again at the test center.

Testing Fees. The ELM fee is $18 and the EPT fee is $18. You must bring a check or money order payable
to ETS. Bring the check to the test. Do not enclose payment. The fee is non-refundable and subject to
change.