Grade 11 ACT Non-Test Session Opt-In Form
The Arkansas Department of Education: Division of Elementary and Secondary Education (ADE:DESE) takes seriously its responsibility to protect the personal information of Arkansas students. In order to maintain the highest level of protection of personal information, it is the policy of the ADE:DESE that your child's/ward's personal information from the Grade 11 ACT State and District administration shall not be disseminated, including to college and universities, without your express consent. IF YOU WISH FOR YOUR CHILD'S/WARD'S SCORES TO BE SHARED WITH COLLEGES OR UNIVERSITIES BASED ON THE DESIGNATION OF RECIPIENTS IN THE NON-TEST SESSION, PLEASE COMPLETE THE FORM BELOW. FAILURE TO RETURN THIS FORM DOES NOT PREVENT YOUR CHILD/WARD FROM PARTICIPATING IN THE GRADE 11 STATE AND DISTRICT ADMINISTRATION OF THE ACT; IT PREVENTS HIS/HER PARTICIPATION IN THE NON-TEST SESSION DURING WHICH HE/SHE WOULD DESIGNATE RECIPIENTS OF HIS/HER SCORES. Additional score reports may be purchased after scores are received by creating or signing in to the ACT web account or by contacting ACT Customer Care at (319) 337-1270. During the non-test session, examinees may also opt-in to the Educational Opportunity Service (EOS) which provides information from colleges, universities, financial aid/scholarship agencies, and organizations that offer educational programs.
Email address *
What is your name? *
What is your student's name? *
Student DOB (MM/DD/YYYY *
What is your address *
Daytime Phone Number *
Night Phone Number *
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