ACT Fee Waiver Request Form

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This form is for 11th and 12th grade students in Sinclair's Upward Bound program. If you plan on taking the ACT (outside of the in-school exam in the spring), please complete this form to receive a fee waiver to take the test for FREE! Please complete at least 2 weeks prior to the registration deadline!

Questions?

Mrs. Branch

kristen.branch@sinclair.edu

937-609-2237 (cell phone)

937-512-2331 (office phone)

First Name *

Last Name *

School *

Belmont

Dunbar

Meadowdale

Ponitz

Thurgood

Other:

Grade Level *

11th

12th

Have you taken the ACT before? *

Yes

If you have taken the ACT previously, what did you score?

What is the date of the test you want to register for? *

YYYY

When is the registration deadline? *

YYYY

Your fee waiver will be sent via email, what is your email address? Please do not use a DPS email address - use gmail, icloud, etc. *

If you have any questions, please put them below and Mrs. Branch will reach out to you.

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