To Request a Report: Complete and submit this form. We will email or fax the requested report within 48 hours. Reports more than 3 years old are no longer considered valid; thus, your request will not be processed. If this is the case, a new assessment will need to be taken. First Name MI Last Name Maiden or Other Birthdate Street Address Your Street Address City State Zip Code Your Current Email Address Phone Number Report Being Requested ACCUPLACER CASAS Send My Report To: Where does your report need to be sent? (Reports will NOT be sent to personal emails or individuals not associated with a training or educational program.) Organization or Institution Individual Name Who is receiving this report? Email or Fax Number Please provide a valid email or fax number of the above individual. Organization Website Valid web address of the receiving organization or institution. CAPTCHA Are you a bot trying to spam us? (Yes or No) This question is for testing whether or not you are a human and to prevent spam.