Utica High School 2017 UCS AP Registration Form
This form needs to be completed and all payments must be made in order to complete your registration for AP test(s).

ALL FIELDS ARE REQUIRED

Payment may either be made by:
cash
personal check
cashier's check
money order
credit card (PaySchools).To pay by credit card, print and follow the directions for PaySchools on your school's website.

NO TEST WILL BE ORDERED UNLESS PAYMENT IS VERIFIED.

Registration Dates:
2-13-17 thru 3-10-17

Late Registration:
3-13-17 thru 3-17-17 [ A late fee of $10.00 will be assessed to the total cost ].

Email address *
First Name: *
(legal first name of person taking the AP exam)
Your answer
Last Name: *
(legal last name of person taking the AP exam)
Your answer
Do you currently receive free or reduced lunch? *
**Free and Reduced Students**
Fee for Free and Reduced Students is $54.00 per test, payable by by cash/ personal check/cashier's check or money order. Payable to: Utica High School (bring to main office Mrs. Jurewicz).
Current Grade Level: *
What school do you currently attend? *
Please select ALL of the tests below you wish to take: *
Required
Total number of tests you are registering for: *
**Note** There is a 3.5% convenience fee added to the total for credit card payments made through PaySchool. CAPSTONE exams are $142.00 each - please adjust your totals accordingly if you are taking these exams.
How do you plan to pay for your AP test(s)? *
NOTE: pre-gridding will be completed in AP classes prior to the exam.
Your answer
Do any of your testing times/dates conflict with another exam? *
Please list the exam conflicts below.
Your answer
Parent/Guardian Name(s): *
Your answer
Parent/Guardian Email: *
Your answer
Parent/Guardian Phone Number: *
Your answer
Please print a copy of this form for your records. Please print an additional copy and turn it in to the bookkeeper with your proof of payment - cash, check or PaySchools receipt (credit card).
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
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