Certiport Appointment Request Form

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Certiport Appointment Request Form

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First Name *

Last Name *

Email *

Date of Birth *

Phone

Student T Number *

Address

City *

State *

MOS exams must be scheduled at least 24 hours in advance. Please select the date for your appointment: *

I am requesting to test on the date selected above. I understand that I may walk in with my PHOTO ID any time between 8:00 am (Thur. 9:30 a.m. instead of 8:00 a.m.) and 3:45 pm (12:45 pm on Friday). I acknowledge that I will not receive a confirmation of this request. *

Is this a retest? *

Yes
No

I have established an account on CERTIPORT.com and registered with my Group by entering my Exam Group ID on the “MY Certiport” tab. *

Yes
No

Certiport Group ID (assigned by instructor): *

Comments:

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