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1	ATTACHMENT B Florida Pre-College Entrance Examination Program SELECTION FORM
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3	DIRECTIONS: Please indicate your district's choice for the pre-college entrance examination. You may select either the PSAT (The College Board) or PLAN (ACT). Each school district should complete and return this form to the Department of Education by July 12, 2007, to Kira Sullivan, Bureau of K-12 Assessment, via email to Kira.Sullivan@fldoe.org, or fax to (850) 245-0781.
4	DISTRICT:
5	CONTACT PERSON:
6	TELEPHONE NUMBER / EMAIL ADDRESS:
7	Mark your district’s selection for the pre-college entrance examination to be administered:
8			PSAT (The College Board)
9			PLAN (ACT)
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11	PLEASE FILL OUT THE FORM BELOW IN ORDER TO PROJECT PARTICIPATION IN THE CHOSEN PRE-COLLEGE ENTRANCE EXAMINATION.
12	District Name	District Number	School Name	School Number	CEEB Code	2007 Grade 10 Projected Enrollment	Estimated Number of 10th graders participating in PSAT or PLAN
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22						TOTAL	TOTAL
23	*Please add rows to adjust for number of schools
24	PLEASE NOTE: This is not the actual order form, but rather a form that provides an estimate to be used by the Department for procurement purposes. EACH SCHOOL WILL SUBMIT AN ORDER TO THE SELECTED CONTRACTOR TO RECEIVE TEST MATERIALS.