AP® Score Withholding Form

School Code:
a
AP Score Withholding Form
®
By signing this form, you confirm that you agree with the terms and conditions on this form. You also certify that you are the person
(or the parent/guardian of the person) whose personal information is being provided for this service. (Archived scores cannot be withheld.)
Provide the information requested and mail this form to AP Services at P.O. Box 6671, Princeton, NJ 08541-6671 or fax to 610-290-8979.
Please print all of the fields except Signature.
First Name:
Middle Initial:
Date of Birth:
Last Name: AP Number(s) Associated with Exam(s):
Year(s) of the Exam(s) to Be Withheld: Street Address: City:
ZIP/Postal Code:
State/Province:
Signature:
(Signature of Student or Parent/Guardian required for processing request)
Country:
Phone Number:
School Name:
City:
State/Province:
ZIP/Postal Code:
Country:
Fill in the circle(s) next to the AP Exam score(s) to be withheld.
Exam Code
 07
 13
 14
 15
 16
 20
 22
 23
 25
 28




31
34
35
36
Exam Name
U. S. History
Art History
Studio Art-Drawing
Studio Art-2-D Design
Studio Art-3-D Design
Biology
Seminar
Research
Chemistry
Chinese Language and
Culture
Computer Science A
Microeconomics
Macroeconomics
English Language and
Composition
Exam Code
 37







40
43
48
53
55
57
58



60
62
64

66
Exam Name
Exam Code
English Literature and
 68
Composition
 75
Environmental Science
 78
European History
 80
French Language and Culture
 82
Human Geography
German Language and Culture
 83
Government and Politics: U.S.
 84
Government and Politics:
 85
Comparative
 87
Latin
Italian Language and Culture
 89
Japanese Language and
Culture
 90
Calculus AB
 93
Exam Name
Calculus BC
Music Theory
Physics B
Physics C: Mech.
Physics C: Electricity and
Magnetism
Physics 1
Physics 2
Psychology
Spanish Language and
Culture
Spanish Literature and
Culture
Statistics
World History
Check the appropriate box(es) below.
 College Indicated on My Answer Sheet: I would like to withhold my score(s) from the college indicated on my registration answer sheet for the exam(s)
indicated above. I am providing payment of $10 per score. I understand that AP Services must receive my form and payment by June 15 of the year in
which I took the exam(s).
 New College – Not Indicated on My Answer Sheet: I would like to withhold my score(s) for the exam(s) indicated above when sending my score report
to the college noted below. I am providing payment of $10 per score in addition to the score send delivery fee checked below.
Note: Exact delivery date will depend on when your request is received and the location of your recipient.

$15: Standard Delivery (approximately 7 to 14 business days)
College Code: Street Address:
City:

$25: Rush Delivery (approximately 5 to 9 business days)
College Name:
State/Province:
ZIP/Postal Code:
Country:
Payment Information
Indicate your method of payment below.
Check/Money Order made payable to AP Exams
Charge my credit card: (check one)
American Express
Name on Credit Card:
Card Number:
Discover
MasterCard
Visa
Exp. Date:
Note: You may release a withheld score by mailing or faxing a signed written request to AP Services. There is no charge to release, but you must pay the fee to have
the score sent.
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