Request to Release Assessment Scores

Print
Press Enter to show all options, press Tab go to next option
In order to release a students placement assessment scores to another college, university, or agency the student must complete this form AND attach a copy of their valid picture id (must not be expired).
Please correct the field(s) marked in red below:

Student Information

 *
Student Information

College or Agency Information: Indicate below where you would like your assessment scores sent to.  Scores cannot be sent to individuals.

 *
College or Agency Information: Indicate below where you would like your assessment scores sent to. Scores cannot be sent to individuals.

Indicate below how you would like assessment scores to be sent.   Must provide fax or email address for college or agency scores are to be sent to. 

 *
Indicate below how you would like assessment scores to be sent. Must provide fax or email address for college or agency scores are to be sent to.

Student Consent to Have Assessment Scores Sent

By completion and submission of this form I verify that:

  • I am the student that this request is being made for; and
  • The photo id provided is valid (not expired).
  • Blue Mountain Community College has my permission to share my assessment scores with the college or agency listed above.

Valid Picture ID  Scan and email or fax a copy of your valid picture ID to:

Fax: 541-278-5885

Email:  testingcenter@bluecc.edu 

A note will be made in your student record regarding receipt of your request and supporting documentation. The copy of your documentation will be purged once your request has been processed. 

 *
  1. To receive a copy of your submission, please fill out your email address below and submit.