TOEFL iBT Exemption Request Form

    *Denotes required field
    Student Information
    *Birthdate
    *Student Mailing Address




    First Parent's Contact Information
    *First Parent's Mailing Address




    School Information
    *I certify that I am currently enrolled at the following school(s) where the primary language of instruction is English
    Please list any additional schools you have attended where the primary language of instruction is English.
    *I certify that I have completed the SSAT exam, and the results of my exam demonstrate fluency in English. I have submitted the following application materials to Stevenson School, which are evidence of my proficiency in English:
    *I have submitted my SSAT scores and writing sample to Stevenson School
    *I certify that I speak English as the first language at home with the following family members:
    *I certify that all the information listed on this form is true and accurately reflects the level of English proficiency I have attained. I also acknowledge that once all necessary score reports have been received this form will be reviewed by the Stevenson School Admission Board, who has the authority to grant or deny my request for an interview.