<p> Alcovy High School AP Exam Registration and Order Form</p><p>Student Full Name:______Grade:______(Please Print) Parent Name:______Daytime Phone #:______</p><p>Courses Offered Check all AP tests you will take Art History Biology Calculus AB Chemistry English Language & Composition English Literature & Composition Environmental Science European History French Language & Culture Human Geography Latin Macroeconomics Music Theory Physics Spanish Language & Culture Statistics Studio Art U.S. Government & Politics US History World History Parent Email Address:______</p><p>Important Notes: AP exam(s)—Case or Money Order ONLY after *NO test will be administered until paid in March 1. full. * Any changes to this agreement will incur *ANY test ordered but not taken will incur all fees and penalties assessed by the a $15 restocking fee assessed by The College Board as the student's College Board. responsibility. *Students who need financial assistance *ALL checks should be payable to AHS and noted with the student’s name and should contact Ms. Davis, AP Coordinator as soon as possible. Total number of tests to be taken by student X Cost of Test (See Reverse) = Balance Due to AHS Payment Options (please mark one option). Payment in Full is due to Alcovy High School by March 16, 2017.</p><p>O I wish to pay for all tests in full at this time (payment attached).</p><p>O I wish to pay for all tests in full by the March 16th deadline.</p><p>O I plan to pay $_____per Week/Month (Circle One) and will be paid in full by March 16, 2017</p><p>O I wish to discuss payment options with the AP coordinator. (Please contact Ms. Didi Davis: 770-784- 4995)</p><p>Please mark your child's current lunch status;</p><p>____Yes, my child receives free and reduced lunch. ____No, my child does NOT receive free and reduced lunch.</p><p>Parent Signature:______Date:______</p><p>Student Signature:______Return completed form to Ms. Holbrook (bookkeeper in Main Office) by March 16, 2017.</p><p>AP Exam Payments are Non-Refundable If a student is Free and Reduced lunch their first AP exam is free and each exam after that will cost $51. Here is the payment plan you can follow depending on the number of test you plan to take. Number of 1 2 3 4 5 6 Tests: Jan 23-Feb 3 $0 $13 $26 $39 $51 $64 Feb 6-17 $0 $13 $26 $38 $51 $64 Feb 20-Mar 3 $0 $13 $25 $38 $51 $64 Mar 6-17 $0 $12 $25 $38 $51 $63 Total: $0 $51 $102 $153 $204 $255</p><p>If a student is not Free and Reduced lunch each AP exam they take will cost $72. Here is the payment plan you can follow depending on the number of test you plan to take.</p><p>Number of 1 2 3 4 5 6 Tests: Jan 23-Feb 3 $18 $36 $54 $72 $90 $108 Feb 6-17 $18 $36 $54 $72 $90 $108 Feb 20-Mar 3 $18 $36 $54 $72 $90 $108 Mar 6-17 $18 $36 $54 $72 $90 $108 Total: $72 $144 $216 $288 $360 $432</p><p>FOR OFFICE USE ONLY:</p><p>Date Paid:______Amount:______Receipt #:______</p><p>Date Paid:______Amount:______Receipt #:______</p><p>Date Paid:______Amount:______Receipt #:______</p><p>Date Paid:______Amount:______Receipt #:______</p><p>Date Paid:______Amount:______Receipt #:______</p><p>Date Paid:______Amount:______Receipt #:______</p>