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Inquiry Form

This form is for institutions only. If you are an examinee or a parent contact ACT.

Required fields marked .

Submitting Institution

Institution Name
ACT College Code
OR ACT High School Code
Primary Contact Prefix
Primary Contact First Name
Primary Contact Last Name
Primary Contact Title
Address
Additional Address Details
City
State/Province
Postal Code
Phone
Email

Questioned Examinee

Examinee First Name
Examinee Middle Initial
Examinee Last Name
Full ACT ID
Date of Birth (mm/dd/yyyy)
Address
City
State/Province
Postal Code

Questioned Test Information

(Please provide the complete test scores for the examinee:)

Composite ACT Score
English
Math
Reading
Science
Test Month
Test Year
Test Location
Reason for questioning Test Scores
Select all that apply
1. 1. Large change in composite
2. 2. Large change in one or more tests
3. 3. Composite score not in line with examinee's academic performance
4. 4. Suspected surrogacy (i.e. someone else taking test for examinee)
5. 5. Composite score does not correlate with examinee's SAT
6. 6. Other
If 'Other', please specify
Is the submitting institution an official ACT Score recipient?
1. Yes
2. No