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Heartland Community College
Student Name:
 
Student Email:
 
Student ID:
 
Verified Identity:
Request_ID:Submit Date:
Former name:
 
       
Completion of this form authorizes the Testing Center to send all of your placement scores from Heartland Community College to the email addresses you indicate below.  
Institution:
 
Authorized recipient email:  
Authorized recipient name: Confirm email:  
I understand by checking this box and typing my name below, I am authorizing the Testing Center to release test scores.
 
Type name below:    
  Submit Request