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Challenge Exam Request Form
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Challenge Exam Request Form
Name
*
First
Last
Student ID Number
Date of Birth
*
MM slash DD slash YYYY
Challenge Exam(s) I will be taking:
*
Computer Literacy
Occupational Math 1
Occupational Math 2
Occupational Math 3
Basic Anatomy
General Anatomy & Physiology
Medical Terminology
Testing Date and Location
*
Please allow 2 business days for MPTC to receive and process your Challenge Exam request.
Monday, November 13th - Fond du Lac - 8:00 a.m. - A210
Tuesday, November 14th - Beaver Dam - 8:00 a.m. - J113
Wednesday, November 15th - West Bend - 8:00 a.m. - N112
Monday, December 4th - West Bend - 8:00 a.m. - N112
Wednesday, December 6th - Fond du Lac - 8:00 a.m. - A210
Friday, December 8th - Beaver Dam - 8:00 a.m. - J113
Email
*
Phone
*
I have reviewed MPTC Credit by Exam Guidelines as set forth on MPTC’s Credit by Exam webpage. I understand any testing fees are non-refundable and become my responsibility to pay once the charge has been placed on my MPTC student account.
*
I acknowledge these guidelines.
Name
This field is for validation purposes and should be left unchanged.
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