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     Testing Department College Placement Testing Contract

    If you are not able to come to the  CBC Test Center to make your TSI Assessment reservation, please contact our Beeville Testing Office and pay the $30.00 TSI Assessment fee with a credit card and then fill out the form below and submit.  If you need assistance - please contact our Beeville Testing Department at (361) 354-2334.
     

    The fields with an “*” you must fill in before submitting the form. 

     

     

     I understand that the TSI Assessment is for all first time students pursuing a degree or Level II certificate.  I understand that if I am going into a Workforce Level I certificate program, I do not have to test.
     

     

     I understand that there is a $30.00 exam fee which must be paid before a reservation is made.  If I am late for my appointment time or miss the appointment, I understand that I will forfeit the $30.00.  When paid by phone - there is a 2% additional fee - total - $30.60
     

     

     I understand that all first-time CBC students must complete a “Pre-Assessment Activity” which consists of the following:  Please enter your initials in each field below – stating that you read and understand each of the four areas of the Pre-Assessment Activity”.   

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       Initials here:                  (1) the importance of this assessment, [Based upon your scores on the TSI Assessment – this will decide whether you are eligible for a college level course or if you will need to take a developmental or preparation course – which will not give you college credit.  A developmental course will help you build your skills so that you will eventually be able to take a college level course.  These courses give you a foundation in the subject area that you need preparation in.  The TSI Assessment exam is very important and we want you to do as well as you possibly can.] 

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     Initials here:                  (2) sample questions, [go to:  http://www.coastalbend.edu/tsiresource/ for sample questions and other resources to help you prepare for the TSI Assessment] 

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     Initials here:                  (3) course options, and [Coastal Bend College offers various course options:  NCBO - Non-Course Based Course - which is a non-semester length course delivered in an intense workshop setting, Integrated Course - which is a course that integrates two areas - such as Reading and Writing together so that a student gets two courses for the time and price of one course, Lecture courses (class-room style course with instructor – face-to-face); Distance Learning courses (class-room setting, but video cameras and microphones link you to other sites with other students.  The instructor may move around from site-to-site to have face time with each area); Internet courses (do your course work from home, but some courses may have you take a proctored exam at a CBC site); Accelerated Learning Academy courses (go to:  http://www.coastalbend.edu/ala/)] 

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     Initials here:                  (4) resources for students.  

     Services available for students at CBC 

     Tutoring 

     Go to:  http://www.coastalbend.edu/tutoring/  

     Financial Aid 

     Go to:  http://www.coastalbend.edu/FinAid/  

     Title V – Laptop Computer/Calculator Loan program  

     Go to:  http://www.coastalbend.edu/tech_request/  

     Library  

     Go to:  http://lrc.coastalbend.edu/about  

     Student Development Advisors  

     Go to:  http://www.coastalbend.edu/Counseling/  

     Testing  

     Go to:  http://www.coastalbend.edu/testing/   

     Housing/Student Activities 

     Go to:  http://www.coastalbend.edu/StudentLife/   

      

     

     A good site to review for additional information is http://www.coastalbend.edu/testingtips/   This is a good site if you need to work on how to prepare an essay response and there are presentations that you can listen to from our case managers.
     

     

     Please complete your Apply Texas Application   at least a week in advance of when you plan to take your TSI Assessment so that a CBC ID number is created for you to use for testing.  You will need the CBC ID number to take the TSI Assessment exam. 

     

     

     I am aware that I must have current picture identification and CBC ID number or SSN if I will not be a CBC student - with me when I come in for testing.
     

     

     I understand that I am not allowed to bring any electronic device (cell phone, smart watch, mp3 player, camera, etc…) into the testing room.  I will leave my personal items in my vehicle, with a friend, or will leave the items at the designated storage area in the Testing Department.  The personal items will be collected and stored at the owner’s risk.  Coastal Bend College will not be responsible for any items lost or stolen.
     

     

     I will report to the test center at least 30 minutes before test time.
     

     

     I understand that seven working days are required for re-scheduling.
     

     

     I understand that special test accommodations require documentation and two weeks’ notice.   TSI Accommodation Request Form 
     

     

     I am aware that if I do not score at college level, I will be required to take developmental courses.   

     

     

    Section

    Score(s) needed to place at College Level

    Course Placement

    Reading Comprehension

    351

    College Level

    Writing

     Essay score of 4 and Writing Multiple Choice 340 
    OR
    Essay of a 5 or higher & Writing Multiple Choice less than 340 & ABE diagnostic level of at least a 4 

    College Level

    Math

    350

    College Level

     

     

     I also understand that there are online resources available from the CBC website.  I acknowledge that I have been encouraged to review them in an effort to help me avoid remediation. 
    The web sites follows:  http://www.coastalbend.edu/testingtips/ 
     http://www.coastalbend.edu/tsiresource/ 
     
       

     

     By typing my name in the signature field, I agree to abide by the above policies. 

     

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     Select the CBC site where you are making your reservation to test:

     

               
       

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     Printed Name of Examinee  - First name:   
                                                       Last name:  

     

    *

     E-mail Address  

       

    *

     CBC ID Number 
    (If you don’t have one & will be a CBC student –go to:   Apply Texas Application - it will take a week to get a CBC ID number) in the meantime you may enter your SSN 

    *

     Phone Number   

       

    *

     Date  

       

     

     Call the Beeville Testing Department at (361) 354-2334 and pay the $30.60 fee with a credit card and ask for the staff to e-mail you and the appropriate testing site a copy of the receipt.   

    If you are wanting a Remote Voucher - note that you must pay CBC the TSI fee and then pay the institution that you will test with a proctor fee.  Also - in the receipt field below: enter Remote Voucher and the Beeville Receipt# along with location of where you will test - Example - Remote Voucher - Beeville # 999999 - Lone Star College 

    The receipt # may be four (4) to six (6) digits long. 

    *

     Receipt #  
    If you are with the TRIO Program and have received a Voucher stating that they are paying for your exam - enter the name of the TRIO Program above - Ex:  Upward Bound / Upward Bound - Rural / ETS/ etc...
     

     Amount Paid:    

    Name of CBC Employee that gave you receipt:     

     

     .  Be aware that the complete TSI Assessment can be one (1) to nine (9) hours in length.  There are three section to the exam - Reading/Writing/ and Math.  Each section could take 1 to 3 hours to complete - based upon the individual.   

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     Date Choice for testing  

    You will need to go to the 
     CBC Online Scheduling Site to schedule your exam.
    (See the yellow highlighted area at the bottom of this form for more details.)
     

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     Please select the areas of the TSI Assessment that you need to take: 
     

                                  

       

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     Signature of Examinee     
    [When you hit submit on this form, this will serve as your electronic signature as if you were signing an official document.]                                                               
     

     

     I am agreeing to take the TSI Assessment at the Coastal Bend College  when I submit this form.  

    By entering my name above  and my date of birth below - I am granting Coastal Bend College the ability to verify any other TSIA scores that I have in the Accuplacer Platform database if I tested at another institution.   If a non-official copy of my TSIA scores from another institution are sent to the CBC Testing Department I am allowing them the right to verify the scores.  

     Here is my date of birth  so that the records can be verified.     

    Once you've paid the fee and received your receipt # and filled out this Electronic TSI Contract  - please go to the  CBC Online Scheduling Site.

    You will first Register - to create an account / then Click Login and enter your e-mail address and the password that you created.

    Select your CBC Test Site / Session or Sessions / and then enter your information.  For the Exam Type - enter TSI.  Then in the last field for Course Information - you will enter " TSI - and section /Date of when payment was made /  Receipt # / Amount paid / and that you've filled out and signed the TSI Contract.   

     

     

     

     

     College Placement Testing Contract Form created – 11/26/13
    Revised 10/4/18
    (Coastal Bend College does not discriminate on the basis of race, creed, color, national origin, gender, age, or disability.)