Request for reapply/repeat examination

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I am in California. I just found out that I failed. I am trying to fill up the "request for reapply/repeat examination". I am confused, what should I put in the "last exam applied for month year" box? Is it the same as the "last exam taken month year" box which is right next to it.

Do I just mail in this one and only page and a check? Or are there other pages I need to fill up?

Thanks in advance

The date of your previous application is what you put in the first one. That will be the date you signed and sent in the app, not the date you took the test. Fill out everything they provided you. If you have any questions about the forms, like if one was left out, call them up and ask.

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