BACE Order Form Please complete this form to order exams and schedule test dates. Step 1 of 7 - BACE Testing Option 0% Please complete the following to begin your order. Note: New Exam Sites should allow 2 business days from completion of the Registration Form (Step 1) before completing the Order Form.1. BACE Testing Option*Which testing option would you like to order and administer?Live Testing Option - both the Knowledge and Practical portions of the exam will be given live at the Exam SiteRemote Testing Option - both the Knowledge and Practical portions of the exam will be given via UF e-Learning Exam Site InformationState*Please select the state in which your Exam Site is located. If your exam site is located outside of the United States, please select the "International" option.--Select State--AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingInternationalAlabama Exam Sites*Please select your exam site:New Century Technology High SchoolMy School is Not ListedAlaska Exam Sites*Please select your exam site:My School is Not ListedArizona Exam Sites*Please select your exam site:Arcadia High SchoolBasha High SchoolCasa Grande Union High SchoolChino Valley High SchoolCorona del Sol High SchoolDesert Vista High SchoolMarcos de Niza High SchoolMcClintock High SchoolMountain Pointe High SchoolParadise Valley High SchoolSaguaro High SchoolSunnyside High SchoolTempe High SchoolWestern Maricopa Education CenterWilliams Field High SchoolMy School is Not ListedArkansas Exam Sites*Please select your exam site:Russellville High SchoolStar City High SchoolVan Buren High SchoolMy School is Not ListedCalifornia Exam Sites*Please select your exam site:California State University - San BernardinoCornerstone International CollegeLynwood High SchoolMervyn M. Dymally High SchoolMorro Bay High SchoolMy School is Not ListedColorado Exam Sites*Please select your exam site:Rock Canyon High SchoolMy School is Not ListedConnecticut Exam Sites*Please select your exam site:My School is Not ListedDelaware Exam Sites*Please select your exam site:My School is Not ListedFlorida Exam Sites*Please select your exam site:Apopka High SchoolBarron Collier High SchoolBradford High SchoolCelebration High SchoolCentral Florida Preparatory SchoolCentral High SchoolCoconut Creek High SchoolColonial High SchoolCornerstone Charter AcademyCountryside High SchoolCrystal River High SchoolCypress Creek High SchoolDixie County High SchoolDr. Phillips High SchoolEast Lake High SchoolFort Walton Beach High SchoolF.W. Springstead High SchoolGulliver Preparatory SchoolHillsborough Community College - BrandonJohn A. Ferguson Senior High SchoolLaBelle High SchoolLake Gibson Senior High SchoolLake Minneola High SchoolLaw Enforcement Officers Memorial High SchoolMadison County High SchoolMainland High SchoolMandarin High SchoolMedical Academy for Science and Technology (MAST)Miami Coral Park Senior High SchoolMiddleton High SchoolNavarre High SchoolNew Dimensions High SchoolNorth Marion High SchoolNortheast High SchoolOcoee High SchoolOlympia High SchoolOrlando Science High SchoolOviedo High SchoolPace High SchoolPalatka High SchoolPalm Beach Lakes High SchoolPalm Harbor University High SchoolPalmetto High SchoolPaul R. Wharton High SchoolPine View SchoolPonte Vedra High SchoolPort Saint Lucie High SchoolRiviera Preparatory SchoolSanta Fe High SchoolSebastian River High SchoolSeminole Ridge Community High SchoolSouth Sumter High SchoolSpanish River Community High SchoolSt. Petersberg CollegeTaylor County High SchoolTimber Creek High SchoolTreasure Coast High SchoolTrenton High SchoolUniversity High SchoolValencia College - Lake NonaVero Beach High SchoolWekiva High SchoolWendell Krinn Technical High SchoolWest Nassau High SchoolWest Port High SchoolWindermere High SchoolWinter Park High SchoolMy School is Not ListedGeorgia Exam Sites*Please select your exam site:My School is Not ListedHawaii Exam Sites*Please select your exam site:My School is Not ListedIdaho Exam Sites*Please select your exam site:My School is Not ListedIllinois Exam Sites*Please select your exam site:My School is Not ListedIndiana Exam Sites*Please select your exam site:Richmond High SchoolWarsaw Area Career CenterWayne High SchoolMy School is Not ListedIowa Exam Sites*Please select your exam site:My School is Not ListedKansas Exam Sites*Please select your exam site:My School is Not ListedKentucky Exam Sites*Please select your exam site:Arvin Education CenterMy School is Not ListedLouisiana Exam Sites*Please select your exam site:My School is Not ListedMaine Exam Sites*Please select your exam site:My School is Not ListedMaryland Exam Sites*Please select your exam site:Applications and Research LaboratoryCecil County School of TechnologyGaithersburg High SchoolNorthwest High SchoolWashington County Technical High SchoolWorcester Technical High SchoolMy School is Not ListedMassachusetts Exam Sites*Please select your exam site:Bay Path UniversitySoutheastern Regional Vocational Technical High SchoolMy School is Not ListedMichigan Exam Sites*Please select your exam site:My School is Not ListedMinnesota Exam Sites*Please select your exam site:My School is Not ListedMississippi Exam Sites*Please select your exam site:My School is Not ListedMissouri Exam Sites*Please select your exam site:Blue Springs South High SchoolRolla High SchoolVan Horn High SchoolMy School is Not ListedMontana Exam Sites*Please select your exam site:Billings Career CenterMy School is Not ListedNebraska Exam Sites*Please select your exam site:My School is Not ListedNevada Exam Sites*Please select your exam site:My School is Not ListedNew Hampshire Exam Sites*Please select your exam site:My School is Not ListedNew Jersey Exam Sites*Please select your exam site:Passaic County Technical Institute STEM AcademyMy School is Not ListedNew Mexico Exam Sites*Please select your exam site:My School is Not ListedNew York Exam Sites*Please select your exam site:My School is Not ListedNorth Carolina Exam Sites*Please select your exam site:Chapel Hill High SchoolDurham Technical Community CollegeEast Chapel Hill High SchoolMy School is Not ListedNorth Dakota Exam Sites*Please select your exam site:My School is Not ListedOhio Exam Sites*Please select your exam site:Miami Valley Career Technology CenterMy School is Not ListedOklahoma Exam Sites*Please select your exam site:Moore Norman Technology CenterPontotoc Technology CenterSouthern Oklahoma Technology CenterSouthwest Technology CenterTri County Technology CenterWestern Technology CenterMy School is Not ListedOregon Exam Sites*Please select your exam site:My School is Not ListedPennsylvania Exam Sites*Please select your exam site:Greater Johnstown Career and Technology CenterMy School is Not ListedRhode Island Exam Sites*Please select your exam site:Regional Career and Technical Center at Coventry High SchoolMy School is Not ListedSouth Carolina Exam Sites*Please select your exam site:Carolina High School and AcademyCatawba Ridge High SchoolCenter for Advanced Technical StudiesWhite Knoll High SchoolMy School is Not ListedSouth Dakota Exam Sites*Please select your exam site:My School is Not ListedTennessee Exam Sites*Please select your exam site:My School is Not ListedTexas Exam Sites*Please select your exam site:Akins Early College High SchoolAmericas High SchoolCedar Ridge High SchoolDel Valle Opportunity CenterIDEA San Benito College PrepJames Martin High SchoolL.C. Anderson High SchoolMontwood High SchoolNacogdoches High SchoolPebble Hills High SchoolSilva Health Magnet High SchoolTexas Academy of Biomedical SciencesVandegrift High SchoolVista Ridge High SchoolMy School is Not ListedUtah Exam Sites*Please select your exam site:My School is Not ListedVermont Exam Sites*Please select your exam site:My School is Not ListedVirginia Exam Sites*Please select your exam site:My School is Not ListedWashington Exam Sites*Please select your exam site:Bonney Lake High SchoolCurtis Senior High SchoolMy School is Not ListedWest Virginia Exam Sites*Please select your exam site:Monroe County Technical CenterWayne High SchoolMy School is Not ListedWisconsin Exam Sites*Please select your exam site:J.I. Case high SchoolMiddleton High SchoolMy School is Not ListedWyoming Exam Sites*Please select your exam site:My School is Not ListedInternational Exam Sites*Please select your exam site:Colegio BandeirantesMy School is Not Listed Shipping Address Confirmation*Please confirm that the address listed below is the address to which the Practical Exam Kit should be shipped.Yes, the information is correct.No, the information is incorrect and needs to be updated.Exam Site NameExam Site 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 New Century Technology High School 2500 Meridian Street N Huntsville, AL 35811 Arcadia High School 4703 E Indian School Rd Phoenix, AZ 85018 Basha High School 5990 S Val Vista Dr Chandler, AZ 85249Casa Grande Union High School 2730 N Trekell Rd Casa Grande, AZ 85122Chino Valley High School 760 E Center St Chino Valley, AZ 86323Corona del Sol High School 1001 E Knox Rd Tempe, AZ 85284Desert Vista High School 16440 S 32nd St Phoenix, AZ 85048Marcos de Niza High School 6000 S Lakeshore Dr Tempe, AZ 85283McClintock High School 1830 E Del Rio Dr Tempe, AZ 85283Mountain Pointe High School 4201 E Knox Rd Phoenix, AZ 85044Paradise Valley High School 3950 E Bell Rd Phoenix, AZ 85032Saguaro High School 6250 N 82nd St Scottsdale, AZ 85250Sunnyside High School 1725 E Bilby Rd Tuscon, AZ 85706-4430Tempe High School 1730 S Mill Ave Tempe, AZ 85281Western Maricopa Education Center - Northwest Campus 13201 West Grand Ave Surprise, AZ 85378Williams Field High School 2076 South Higley Rd Gilbert, AZ 85295Russellville High School 2203 South Knoxville Ave Russellville, AR 72802Star City High School 400 East Arkansas St Star City, AR 71667Van Buren High School 2001 Pointer Trail East Van Buren, AR 72956California State University San Bernardino Biological Sciences 5500 University Parkway San Bernardino, CA 92407Cornerstone International College 24301 Southland Dr Suite 214 Hayward, CA 94545Lynwood High School 4050 E Imperial Hwy Lynwood, CA 90262Mervyn M. Dymally High School 8800 San Pedro St Los Angeles, CA 90003Morro Bay High School 235 Atascadero Rd Morro Bay, CA 93442-1516Rock Canyon High School 5810 McArthur Ranch Rd Highlands Ranch, CO 80124Apopka High School 555 W Martin St Apopka, FL 32703Barron Collier High School 5600 Cougar Dr Naples, FL 34109Bradford High School 581 N Temple Ave Starke, FL 32091Celebration High School 1809 Celebration Blvd Celebration, FL 34747Central Florida Preparatory School 1450 Citrus Oaks Ave Gotha, FL 34734Central High School 14075 Ken Austin Pkwy Brooksville, FL 34613Coconut Creek High School 1400 NW 44th Ave Coconut Creek, FL 33066Colonial High School 6100 Oleander Dr Orlando, FL 32807Cornerstone Charter Academy 5903 Randolph Ave Orlando, FL 32809Countryside High School 3000 FL-580 Clearwater, FL 33761Crystal River High School 3195 Crystal River High Dr Crystal River, FL 34428-3322Cypress Creek High School 1101 Bear Crossing Dr Orlando, FL 32824Dr. Phillips High School 6500 Turkey Lake Rd Orlando, FL 32819Dixie County High School 17924 SE US-19 Cross City, FL 32628East Lake High School 1300 Silver Eagle Dr Tarpon Springs, FL 34688Fort Walton Beach High School 400 Hollywood Blvd SW Fort Walton Beach, FL 32548F.W. Springstead High School 3300 Mariner Blvd Spring Hill, FL 34609Gulliver Preparatory School 6575 North Kendall Dr Pinecrest, FL 33156Hillsborough Community College - Brandon 10451 Nancy Watkins Dr Tampa, FL 33619John A. Ferguson Senior School 15900 SW 56th St Miami, FL 33185LaBelle High School 4050 E Cowboy Way LaBelle, FL 33935Lake Gibson Senior High School 7007 N. Socrum Loop Rd Lakeland, FL 33809Lake Minneola High School 101 N Hancock Rd Minneola, FL 34715Law Enforcement Officers Memorial High School 300 NW 2nd Ave Miami, FL 33128Madison County High School 2649 W US 90 Madison, FL 32340Mainland High School 1255 W. International Speedway Blvd Daytona Beach, FL 32114Mandarin High School 4831 Greenland Rd Jacksonville, FL 32258Medical Academy for Science and Technology (MAST) 1220 NW 1st Ave Homestead, FL 33030Miami Coral Park Senior High School 8865 SW 16th St Miami, FL 33165Middleton High School 4801 N 22nd St Tampa, FL 33610Navarre High School 8600 High School Blvd Navarre, FL 32566New Dimensions High School 4900 Old Peasant Hill Rd Kissimmee, FL 34759North Marion High School 151 W Hwy 329 Citra, FL 32113Northeast High School 700 NE 56th St Oakland Park, FL 33334Ocoee High School 1925 Ocoee Crown Point Pkwy Ocoee, FL 34761Olympia High School 4301 S Apopka Vineland Rd Orlando, FL 32835Orlando Science High School 2600 Technology Dr Suite 250 Orlando, FL 32804Oviedo High School 601 King St Oviedo, FL 32754Pace High School 4065 Norris Rd Pace, FL 32571Palatka High School 302 Mellon Rd Palatka, FL 32177Palm Beach Lakes High School 3505 Shiloh Dr West Palm Beach, FL 33407Palm Harbor University High School 1900 Omaha St Palm Harbor, FL 34683Palmetto High School 1200 17th St West Palmetto, FL 34221Paul R. Wharton High School 10414 E Columbus Dr. Tampa, FL 33619 Pine View School 1 Python Path Osprey, FL 34229Ponte Vedra High School 460 Davis Park Rd Ponte Vedra Beach, FL 32081Port Saint Lucie High School 1000 Darwin Blvd Port St. Lucie, FL 34953Riviera Preparatory School 9775 SW 87th Ave Miami, FL 33176Santa Fe High School 16213 US-441 Alachua, FL 32615Sebastian River High School 9001 90th Ave Sebastian, FL 32958Seminole Ridge Community High School 4601 Seminole Pratt Whitney Rd Loxahatchee, FL 33470South Sumter High School 706 N Main St Bushnell, FL 33513Spanish River Community High School 5100 Jog Rd Boca Raton, FL 33496St. Petersberg College 2465 Drew St. Clearwater, FL 33765Taylor County High School 318 North Clark St Perry, FL 32347Timber Creek High School 1001 Avalon Park Blvd Orlando, FL 32828Treasure Coast High School 1000 SW Darwin Blvd Port St. Lucie, FL 34953Trenton High School 1013 North Main St Trenton, FL 32693University High School 1000 W. Rhode Island Ave Orange City, FL 32763Valencia College - Lake Nona 12350 Narcoossee Rd Orlando, FL 32832Vero Beach High School 1707 16th St Vero Beach, FL 32960Wekiva High School 2501 N. Hiawassee Rd. Apopka, FL 32703Wendell Krinn Technical High School 7650 Orchid Lake Rd New Port Richey, FL 34653West Nassau High School 1 Warrior Dr Callahan, FL 32011West Port High School 3733 SW 80th Ave Ocala, FL 34481Windermere High School 5523 Winter Garden Vineland Rd Windermere, FL 34786Winter Park High School 2100 Summerfield Rd Winter Park, FL 32792Richmond High School 300 Hub Etchison Pkwy Richmond, IN 47374Warsaw Area Career Center 1 Tiger Lane Warsaw, IN 46580Wayne High School 9100 Winchester Rd Fort Wayne, IN 46819Arvin Education Center 1650 Colonels Dr La Grange, KY 40031Applications and Research Laboratory 10920 Clarksville Pike Ellicott City, MD 21042Cecil County School of Technology 912 Appleton Rd Elkton, MD 21921Gaithersburg High School 101 Education Blvd Gaithersburg, MD 20877Northwest High School 13501 Richter Farm Rd Germantown, MD 20874Washington County Technical High School 50 West Oak Ridge Dr Hagerstown, MD 21702Worcester Technical High School 6290 Worcester Hwy Newark, MD 21841Southeastern Regional Vocational Technical High School 250 Foundary St South Easton, MA 02375Bay Path University 588 Longmeadow St Longmeadow, MA 01106Blue Springs South High School 1200 SE Adams Dairy Pkwy Blue Springs, MO 64014Rolla High School 900 Bulldog Run Rolla, MO 65401Van Horn High School 1109 S Arlington Ave Independence, MO 64053Billings Career Center 3723 Central Ave Billings, MT 59102Passaic County Technical Institute STEM Academy 45 Reinhardt Rd Wayne, NJ 07470Chapel Hill High School 1709 High School Rd Chapel Hill, NC 27516Durham Technical Community College 2401 Snow Hill Road Durham, NC 27703East Chapel Hill High School 500 Weaver Dairy Rd Chapel Hill, NC 27514Miami Valley Career Technology Center 6800 Hoke Rd Englewood, OH 45315Moore Norman Technology Center 4701 12th Avenue NW Norman, OK 73069Pontotoc Technology Center 601 West 33rd St Ada, OK 74820Southern Oklahoma Technology Center 2610 Sam Noble Pkwy Ardmore, OK 73401Southwest Technology Center 711 W Tamarack Rd Altus, OK 73521Tri County Technology Center 6101 Nowata Rd Bartlesville, OK 74006Western Technology Center 621 Sooner Dr Burns Flat, OK 73624Western Technology Center 621 Sooner Dr Burns Flat, OK 73624Western Technology Center 621 Sooner Dr Burns Flat, OK 73624Greater Johnstown Career and Technology Center 445 Schoolhouse Rd Johnstown, PA 15904Regional Career and Technical Center at Coventry High School 40 Reservoir Rd Coventry, RI 02816Regional Career and Technical Center at Coventry High School 40 Reservoir Rd Coventry, RI 02816Carolina High School and Academy 2725 Anderson Rd Greenville, SC 29611Catawba Ridge High School 1180 Fort Mill Parkway Fort Mill, SC 29715Center for Advanced Technical Studies 916 Mount Vernon Church Rd Chapin, SC 29036White Knoll High School 5643 Platt Springs Rd Lexington, SC 29073Akins Early College High School 10701 S 1st St Austin, TX 78748Americas High School 12101 Pellicano Drive El Paso, TX 79938Cedar Ridge High School 2801 Gattis School Rd Round Rock, TX 78664Del Valle Opportunity Center 5301 Ross Rd Del Valle, TX 78617IDEA San Benito College Prep 2151 Russel Lane Del Valle, TX 78586James Martin High School 4501 W. Pleasant Ridge Rd Arlington, TX 76016L.C. Anderson High School 8403 Mesa Dr Austin, TX 78759Montwood High School 12000 Montwood Dr El Paso, TX 79936Nacogdoches High School 4310 Appleby Sand Rd Nacogdoches, TX 75965Pebble Hills High School 14400 Pebble Hills Blvd El Paso, TX 79938Silva Health Magnet High School 121 Val Verde St El Paso, TX 79905Texas Academy of Biomedical Sciences 300 Trinity Campus Circle Drive TRWF 4th Floor Fort Worth, TX 76102Vandegrift High School 9500 McNeil Drive Austin, TX 78750Vista Ridge High School 200 S. Vista Ridge Blvd Cedar Park, TX 78613Bonney Lake High School 10920 199th Ave Ct E Bonney Lake, WA 98391Curtis Senior High School 8425 40th St W University Place, WA 98466Wayne High School 100 Creig Rd. Wayne, WV 25570Monroe County Technical Center 74 James Monroe Dr Lindside, WV 24951J.I. Case High School 7345 Washington Ave Racine, WI 53406Middleton High School 2100 Bristol St Middleton, WI 53562Colegio Bandeirantes Rue Estela, 268 Sao Paulo-SP 04011-001 BrazilWhoops! We do not appear to have your exam site information on file. Please select "No, the information is incorrect and needs to be updated" in the box above, and then complete the required fields. Order Details and Payment Information 1. EXAM ORDER - Select the items you would like to order:Biotechnician Assistant Credentialing Exam Order*Please indicate if you are ordering for first attempts, or retakes. The $150 exam fee includes both the Knowledge and Practical exams. Included FREE for both options is the Online Practice Exam for high-quality test preparation that is aligned to the BACE and the Industrial Biotechnology Curriculum Framework.First Attempt ($150)Retake - Choose options belowBACE Retake Order*Please select from the following options: Retake - Full Exam ($50) Retake - Knowledge Exam ONLY ($25) Retake - Practical Exam ONLY ($25) 2. EXAM QUANTITIES - Indicate how many of each item you would like to order:Biotechnician Assistant Credentialing Exam*Full Exam - 1st Attempt Price: $150.00 Quantity: Biotechnician Assistant Credentialing Exam Retakes*Retake - Full Exam Price: $50.00 Quantity: BACE Retake - Knowledge Exam ONLY* Price: $25.00 Quantity: BACE Retake - Practical Exam ONLY*Retake - Practical Exam ONLY Price: $25.00 Quantity: Remote Exam Order TotalFull Exam - First AttemptRemote Exam Order TotalFull Exam - RetakesRemote Exam Order TotalPartial Exam - Retakes 3. SELECT REMOTE TESTING WINDOWPlease enter the dates on which you'd like your BACE testing window to start and finish. PLEASE NOTE: 1) The testing window should be between 1 and 14 days2) Instruct the candidates to complete the exam within the first half of that testing window. 3) Scores will be sent out two weeks from the close of your testing window. Testing Window Begins On:* Date Format: MM slash DD slash YYYY Testing Window Ends On:* Date Format: MM slash DD slash YYYY Order Details and Payment Information 1. EXAM ORDER - Select the items you would like to order:Biotechnician Assistant Credentialing Exam Order*Please indicate if you are ordering for first attempts, or retakes. The $150 exam fee includes both the Knowledge and Practical exams. Included FREE for both options is the Online Practice Exam for high-quality test preparation that is aligned to the BACE and the Industrial Biotechnology Curriculum Framework.First Attempt ($150)Retake - Choose options belowBACE Retake Order*Please select from the following options: Retake - Full Exam ($50) Retake - Knowledge Exam ONLY ($25) Retake - Practical Exam ONLY ($25) 2. EXAM QUANTITIES - Indicate how many of each item you would like to order:Biotechnician Assistant Credentialing Exam*Full Exam - 1st Attempt Price: $150.00 Quantity: Biotechnician Assistant Credentialing Exam Retakes*Retake - Full Exam Price: $50.00 Quantity: BACE Retake - Knowledge Exam ONLY* Price: $25.00 Quantity: BACE Retake - Practical Exam ONLY*Retake - Practical Exam ONLY Price: $25.00 Quantity: Live Exam Order TotalFull Exam - First AttemptLive Exam Order TotalFull Exam - RetakesLive Exam Order TotalRetake Portion OnlyShipping - Full ExamTotal Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Shipping - Retakes (Full Exam)Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Shipping - Retakes (PE Only)Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)*Total Cost (Shipping Included)* 3. SELECT LIVE EXAM DATES :Multiple Test Dates Required?*Is the Candidate pool large enough to require testing sessions scheduled over multiple days?YesNoNumber of Test Days Required*Please indicate how many testing days you would like to schedule:Please enter a number greater than or equal to 2.Test Dates*Please provide the date range (or individual dates) for which you would like to schedule the Knowledge and Practical portions of the exam.Exam Dates*Please provide a list of dates for which you would like to schedule the Knowledge and Practical portions of the exam. You may enter additional dates by pressing the "+" to add more rows to the table.Exam Portion (Knowledge or Practical)Date Date of Knowledge Exam* Date Format: MM slash DD slash YYYY Date of Practical Exam* Date Format: MM slash DD slash YYYY Payment Information:Payment Method*Please select your preferred payment method:Online with Credit Card or PCardCheckPurchase Order Payment is not collected immediately. An invoice will be generated and emailed to the Billing Contact with payment instructions. Checks and Purchase Orders should be made payable to the University of Florida.Name* First Last Email*A summary of this order will be sent to the email address provided here. Are you the Billing Contact?*YesNo Please provide the required information for the Billing Contact:Name* First Last Email* Phone*Phone ExtensionAddress* 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
