Transcription of ACT Test Information Release Order Form
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ACT Test Information Release Order Form
Test Information Release Order form 2017 2018 ACT, Restricted when data is present. 2017 by ACT, Inc. All rights reserved. This is a new permanent addressPLEASE PRINTName of Examinee (as given when the ACT test was taken) Date of BirthStreet AddressCity State/Province ZIP/Postal Code ( )ACT ID Telephone NumberLocation of test center where the ACT test was takenI understand that by signing below, I consent to the ACT Privacy Policy ( ), which is incorporated into this form by reference, including consent to the collection of personally identifying Information and its subsequent use and disclosure.
Test Information Release Order Form 2018–2019 ACT, Inc.-Confidential Restricted when data is present. © 2018 by ACT, Inc. All rights reserved.
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