ARIZONA CLASSROOM TEACHER SPANISH PROFICIENCY EXAM



Date | |Semester | | |

| |_____________________ |__________ |__________________________________________ |

|Name |(first) |(initial) |(last) |

|SS# NAU ID# |

|Mailing Address (include apt #): |_____________________________________________ |

| | |

|City, State and Zip Code: |_____________________________________________ |

| | |

|Daytime Phone Number |_____________________________________________ |

|(please include area code): | |

|Email Address: | |

| |_____________________________________________ |

|Initial Examination of the exam |Yes | |No |If this is the first |

|(circle one) | | | |time that you take this|

| | | | |exam, skip to |

| | | | |Registration Fee |

|Retaking Examination of both parts |Yes | |Date of previous Examination: |___________ |

|(Oral & Written) |__________ | | | |

| | | | | |

|Retaking Oral Portion of Examination |Yes | |Date of previous Examination: |___________ |

| |__________ | | | |

| | | | | |

|Retaking Written Portion of Examination: |Yes___________ | |Date of previous Examination: |___________ |

|Registration Fee |$35.00 ** | | |

|Total Fee must be enclosed |$___________ |Check or Money Order Number |___________ |

Please make your check or money order payable to NAU and mail with your application to:

Northern Arizona University

P. O. Box 6236

Yuma, AZ 85366

ATTN: Araceli Duran, Admissions

Credit card payments may be made over the phone by calling 317-6400, but you must fax your application via fax to Dr. Amalia Garzón, Assistant Professor of Spanish, Modern Languages, NAU-Yuma at 928-3176419.

If your application and payment have not been received TWO DAYS before the exam date, you will be scheduled for the next semester. You will forfeit the fee paid if you fail to attend or fail to reschedule.

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