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REQUEST FOR CUNY SKILLS SCORES
                  ____________________________________________________________________
Name:        Last                              First                            Middle                     Maiden or Other                   
                  _____________________________________________________________________
Address:    Number & Street                    Apt#                               City                    State

______/______/______                   From:__________________ To:________________________
Social Security #                                        Hunter Attendance
_____/______/_______                  ______/_______/_____
Date of Orig. Test          Date of Retest (if taken)
Complete CUNY School where the scores are to be sent:                           
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Student Signature Date