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Placement Test Request Form

If you are not in the Lansing area you may set up a proctor at another college,  university, or testing center in your vicinity. You will want to check with them first to make sure they are willing to proctor your tests.

Please review our Placement Testing Proctor Guidelines and completely fill out the form below.

General Information ( * Denotes a required field)

*Have you applied to the college and completed your admissions process and received a student number?
Yes No

If not, you must apply to the college before you can take the placement test. Please go to to apply.

What type of placement test do you need (Check all that apply)? Please be aware that math courses require reading and writing levels as well.

Reading    Writing    Math

What semester do plan on attending?

Student Information

*Student Name      

*Student #                    SS#'s are not accepted.

*Birth Date                 

*Student Telephone     

*Email Address            

*Verify Email Address    

Proctor Information

*Proctor Name      (What's this?)

*Proctor Location 

*Proctor Address

*Proctor City     

*Proctor State      

Note: If you are using an international address please select "International" as your Proctor State. Then type in your Country, State or Province below.

Country, State or Province: . 

*Proctor Zip/Postal code     

*Proctor Email            

*Verify Proctor Email     

*Proctor Telephone     

 Proctor Fax     

*Have you used this proctor location previously? If yes, when?     

If your proctor charges a fee please list their fee in the box below

*Do you know the proctor on a personal or professional basis? 
Yes No

If yes,  Please explain. 

Do you require special testing accommodations, if so please explain. (Please note that documentation may need to be provided for your request)

Other Comments


The Online Testing Support Office will not process your request, unless the form is complete.

 The Online Testing Support Office requires seven to ten businesses days to process a request. You will receive an email notification once your request is processed.

 For additional information, please visit our website at

 If you have any questions or concerns, please contact our office at:

 1-800-644-4522 x5503 or by email at


Assessment Center at Lansing Community College

Assessment Center
Course Testing - TLC 104

Placement Testing - GB StarZone
Phone: (517) 267-5500
Additional contact information »

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