SCA College of Svatý Sebesta
Request to Test Out of a Class

Complete and Mail this form to:
Chancellor of Svatý Sebesta
PO Box 1 Vermillion SD  57069

Please Fill out the following information by printing legibly:

Required Information:
Information contained in this section is used by the Collegium to maintain Registrar and Attendance records. It may be made available to other SCA entities through published Reports or on the Collegium's web site.

Name and/or Designation of Class:  ____________________________________________________

Date/Location of Session you can Test Out at:  ____________________________________________

Your SCA Name:  ______________________________________________________________
Local SCA Group: __________________________________________________________
SCA Kingdom: __________________________________________________________
Have you previously registered as a student with the Collegium?  Yes ___  No ___

If you have taken classes or registered using a name other than the above, what name(s) have you used?     
__________________________________________________________________
__________________________________________________________________
Optional Information:
Information in this section may only be used internally within the Collegium.
Mundane Name: __________________________________________________
Mundane Address: __________________________________________________
__________________________________________________
__________________________________________________
Phone: (    )  __________      E-mail Address: _______________________________

Check here if you would be interested instructing a class or workshop.  _____

To Be Completed by Collegium Staff
Date Received: ____________       Received by: ______________________________
Date Received by Registrar:  _______________
Date Entered:  __________ by  _____________________________________________
Confirmation Mailed to:   ___  Student      __  Chancellor      __  Local Group     __ Instructor

Form Revision Date: March 24, 2002