Test Center Reimbursement IMPORTANT: You must have used a Modern States CLEP voucher and provide a copy of your CLEP exam score to request test center reimbursement. Please note, it takes approximately 8-10 weeks to process a reimbursement request. Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Which High School Did/Will You Graduate From*If you are a TheDream.US Scholar, please select that option instead of a specific high school.Please Select A SchoolAcademy for Careers in Television & Film (TvF)Bronx Academy of LettersBrooklyn High School of the ArtsCentral Park East High SchoolEast Bronx Academy for the FutureEpic North High SchoolFrederick Douglas Academy IIGeorge Westinghouse Career and Technical Education High SchoolHigh School for Health, Education and Research Opportunities High School (HERO)Jamaica Gateway to the SciencesKIPP New York City College Prep High SchoolLaboratory School of Finance and TechnologyLower Manhattan Arts Academy (LOMA)Mesa Charter High SchoolPark East High SchoolRenaissance High School for Musical Theater and The ArtsSouth Bronx Preparatory SchoolTYWLS BronxTYWLS BrooklynTYWLS East HarlemThe Bronx Latin SchoolThe Collegiate Institute for Math and ScienceThe Heritage SchoolUnion Square Academy for Health SciencesUrban Assembly School for the Performing ArtsI am a TheDream.US ScholarWhat is your TheDream.US App ID?*Found at the top of your ISTS PortalExam(s) Taken*Hold the CTRL key (COMMAND on a Mac) and click the exams to select them. Please select all of the exams you are requesting reimbursement for. Click any item again to deselect it. Remember to keep the CTRL/COMMAND key pressed.Analyzing and Interpreting LiteratureBiologyCalculusChemistryCollege AlgebraCollege CompositionHistory of the United States IIntroductory PsychologyIntroductory SociologyPrecalculusSpanish LanguageExam Taken*Select a CourseAnalyzing and Interpreting LiteratureBiologyCalculusCollege AlgebraCollege CompositionHistory of the United States IIntroductory PsychologyIntroductory SociologyPrecalculusSpanish LanguageOther Course (Requires Approval)Please Select Which Course*Select a CourseAmerican GovernmentAmerican LiteratureChemistryCollege Composition ModularCollege MathematicsEnglish LiteratureFinancial AccountingFrench LanguageGerman LanguageHistory of the United States IIHuman Growth and DevelopmentHumanitiesInformation SystemsIntroduction to Educational PsychologyIntroductory Business LawNatural SciencesPrinciples of MacroeconomicsPrinciples of ManagementPrinciples of MarketingPrinciples of MicroeconomicsSocial Sciences and HistoryWestern Civilization I: Ancient Near East to 1648Western Civilization II: 1648 to the PresentSecond attempt to obtain the required score on this exam? Yes, this is my second attempt Test Center Fee ($)*Attached Receipt(s)* Drop files here or Accepted file types: jpg, jpeg, gif, png, bmp, tiff, pdf. Exam Score*Candidate Score Report*Accepted file types: jpg, jpeg, gif, png, bmp, tiff, pdf.Voucher Number*Please enter the voucher number provided by Modern States for this examRequest ID