Attachment A

Transcript

1 Attachment A est Assessing Secondary Completion (TASC™) Application for T The University of the State of New York THE STATE EDUCATION DEPARTMENT High School Equivalency (HSE) Office (518) 474-5906 [email protected] Directions and Application to take the TASC™ : ™ Set up your Online Account for the TASC™ at: Online Registration for TASC 1. Account The TASC™ Application starts on the ne 2. age application. xt page. It is a 6-p each response and sign the application in blue ink  . Applicants must complete This application must be printed and mailed to the TASC Test Center where you would  DO NOT MAIL TO THE STATE EDUCATION DEPARTMENT. take the test. like to  A new application must be submitted to the Test Center each time one applie s to take a TASC™. Find a TASC™ Te 3. nter where you would like to te st: Find a TASC Test Center st Ce It is recommended that all applicants review TASC™ preparation materials: 4. www.tasctest.com for the TASC™ by contacting their local High are strongly encouraged to prepare 5. Applicants rograms School Equivalency (HSE) Preparation Program: HSE Preparation P A 7. dditional important information and online resources can be found after the application, on the last two pages of this document. (1)

2 Application - Continued ( Test Assessing Secondary Completion (TASC™) Page 1 of 6) Print and mail this completed application to the Test Center where you would like to test. Middle Initial Legal First Name ( Name): Legal Last Name ( Name): TASC™ - Online Account and Testing History TASC™? Have you created an online account to take the 1. No Yes r T you at is wh If yes, ? , Number UUID , or dentification Unique I niversal ASC™ U __ _ _ __ - __ __ __ - __ __ __ t to g If yo u have no t ye e a UUID av u already h if yo ecall u do not r o. If yo o s , please d umber UID n et a U reated an online accoun t c nu mber, please check. Information on how to proceed and the online form to create an account at: Create an Online Account. scores. A UUID number will also help ensure that your HSE Once you create an online account you can check your unofficial TASC™ diploma or transcript wil l be mailed without errors or delays. 2 . Social Security Number (9 digits) or Other Government ID Number _ - __ ___ __ ____________________ _ __ _ - __ _ _ __ ___ ___ _ __ It is important to report the same SSN or Other Government ID each time you apply . Once you create on online account and to test a social security number. not have a UUID number, that number should always be used. Please note that a UUID Number is 4. 3. Date of birth: Number Telephone _____ / _____ / __________ - __ __ __ __ __ __ - __ __ __ __ dd yyyy mm -9999 above. -999 If you do not have a phone, enter 999 _______________________ : dress Email 5. Ad _______________________ : Confirm Email Address s nformation, the applicant can use their mportant i It i very important to provide an email address. In addition to sending i . email address to check unofficial scores at the DRC Test Portal, after taking the TASC ™ Mailing Address or PO Box Number: 6. Name: __________________________________________________ (Use full words, such as Street, Avenue, etc.) _ ___________________________________________ Office Box OR Post Street Address Apartment #, Suite, Floor, Etc. (As applicable) : _______________ Zip Code _____________ _______________ : (U se actual city name) : ___________________ _ State : City (2)

3 Application Continued (Page 2 of 6) Test Assessing Secondary Completion (TASC™) - Print and mail this completed application to the Test Center where you would like to test. Middle Initial Name): Legal First Name ( Name): Legal Last Name ( 6. County of Residence: 7 . The following types of Government ID can be used to confirm identity. Check only one: Driver’s ID - Non Passport Driver’s License State Alternative Identification NYC Identification Card Number Permanent Residence Card Alien Card Consulate Issued Identification Other _______________________________ Military ID Yes ew York State? (after 2014) in N Have you previously taken the GED® (before 2014) or the TASC™ 8. No Name and l ast TASC™ or GED® :_______________________________________ ocation of Test Center where you took your l t: La st Tes Date o f ____ / ____ / ________ mm d d yyyy ur most r e Test Center. n to th d applicatio a copy of yo mplete co his ith t ranscript w t HSE t ed that yo recommend It is u mail ecen Residency Requirement: t for a Minimum of 30 Days Prior to Testing Applicant must be NYS Residen 1) document that of one ( not the original - Applicant must provide a copy - ms their residence in New York State for confir at least thirty (30) days prior to taking the TASC™. Check which valid form of proof of r esidency is attached: Monthly bank or credit card statement Valid NYS Driver’s License NYS “Non driver’s ID” Voter registration card - Automobile Registration Selective Service card Copies of most recent completed NYS tax returns Homeowners or renter’s insurance policy Telephone utility bills or payment of service such as cable TV -2 form and corresponding W Attendance as a juror in NYS NYS apartment lease signed by landlord Municipal ID (NYC) Deed or mortgage statement (3)

4 - 3 of 6) Continued (Page Application Test Assessing Secondary Completion (TASC™) Print and mail this completed application to the Test Center where you would like to test. First Name ( Middle Initial Name): Legal Name): Legal Last Name ( ge 19 Age Eligibility Requirements: Applicants Under A Applicants who are nineteen (19) years of age or older by the first day of testing do not as need to meet age eligibility criteria, described for 16, 17, and 18- year -olds. on the first day of testing must provide both Proof of NYS Applicants who are seventeen (17) or eighteen (18) years of age Eligibility. Age Proof of and Residency NYS requires applicants to reach Maximum Compulsory School Attendance Age (MCSSAA). Applicants reach MCSAA after the end of the school year (June 30th) in which they turn sixteen (16), or in some districts like NYC, Buffalo, and others, age seventeen (17). mail the required form with this application to the Test Center. eck all age eligibility criteria that apply and Ch The a foreign born pplicant is t F Attachmen See: . 12 schools in the United States - never attended K and The a pplicant has reached “maximum compulsory school attendance age” and one year has passed since the applicant was last Attachment B enrolled in a program leading to a high school diploma. See: was a member of a high school class that and has reached “maximum compulsory school attendance age” The a pplicant Attachment B already graduated. See: has reached “maximum compulsory school attendance age” pplicant The a is enrolled in an Alternative High School and Equivalency Preparation ( ASHEP) Program. T- TAF See: The a pplicant Attachment D See: . has applied to the United States Armed Forces pplicant Attachment D See: secondary institution. - has applied to college or post The a The a pplicant is currently enrolled in a Job Corps program. See: Attachment D Attachment E See: is incarcerated or institutionalized. The a pplicant The applicant is an adjudicated youth or is under the direction of a prison, jail, d etention center, court, parole or probation office. See: Attachment E See: The a pplicant has reache d “maximum compulsory school attendance age” and has been home schooled. Attachment B (4 )

5 4 of 6) Continued (Page - Application Test Assessing Secondary Completion (TASC™) Print and mail this completed application to the Test Center where you would like to test. First Name ( Legal Last Name ( Middle Initial Name): Legal Name): conditions: 2) and dency i Proof of NYS Res 1) two the first day of testing must meet on Applicants who turn sixteen (16) years of age Compulsory School Attendance Age” ed “M aximum Proof that the applicant has reach . The Applicant must check which one of the following age eligibility criteria applies to their situation: and ompulsory school attendance age” has reached “maximum c pplicant The a is enrolled in an Alternative High School Equivalency Preparation (ASHEP) Program. See: T- TAF has reached “maximum compulsory school attendance age” The a and has applied to the United Stated Armed Forces. pplicant See: Attachment D pplicant secondary - has applied to a college or post and The a ol attendance age” has reached “maximum compulsory scho institution. Attachment D See: Attachment B See: has been home schooled. and has reached “maximum compulsory school attendance age” pplicant The a Additional Demographic Information Unspecified 1 Female . Gender : Male ) 2 . R ace (Check all that apply e American Indian/Alaskan Nativ Native Hawaiian/Other Pacific Islander lack/African American B ite Asia Wh n Hispanic or Latino : Ethnicity 3 Not Hispanic or Latino . 4 . Home Language (Select One) : Karen English Spanish Uzbek Burmese French Bengali Chinese: Mandarin/Cantonese tian Creole Hai Urdu Arabic Somali Russian Other Checking the box affirms that all questions have been answered truthfully and accurately . that I certify that the information I have provided is accurate and complete to the best of my knowledge. I understand that intentionally giving false information could result in the invalidation of my test results. (5 )

6 5 of 6) Continued (Page - Application Test Assessing Secondary Completion (TASC™) Print and mail this completed application to the Test Center where you would like to test. First Name ( Legal Last Name ( Middle Initial Name): Legal Name): Request to Schedule a TASC ™ See: Find a TASC Test Center Test Center and Location (Where Applicant 1. Prefers to Test) : Name of _ ___ ___ __ 3- Digit Test Center Code: be will You location. are listed for that that dates dicate in only to Be sure . the Test Center listed above rom f Preferred Test Date(s) 2. contact ed by the Test Center after your application is received to confirm your testing date . First Choice: __ ______ / ___ Second Choice: ______ / ________ ______ / _ / ________ yyyy dd mm yyyy dd mm e . Be sure to check that th Indicate whether you prefer to take a Paper Based Test (PBT) or a Computer Based test (CBT) Test Types: 3. that selected test date . Test Center that you prefer offers the type of testing on your you want to take Computer esting Type Preference: T No Preference -Based Testing (CBT) Paper -Based Testing (PBT) : 4. Check Requested Test Form Type English Audio Spanish Braille English Braille Spanish Print English Print English Large Print Spanish Audio Spanish Large Print Were you officially referred from an HSE test preparation program No Yes ? 5. ________________________________ ________________________________ If yes, what was the name of the preparation program? What is the f ive (5) digit Prep Program Code __ __ __ __ __ Your Prep Program should m ail a copy of the T -TAF referral form to the Test Center with this application . http://www.acces.nysed.gov/common/acces/files/hse/attachmentt.pdf T- TAF can be found at: The 6. Identify the TASC ™ subtests that you wish to take : I wish to take all five (5) subtests. Mathematics Social Studies Writing Reading Science Testing Accommodations -home/test Information at: https://tasctest.com/demo -takers/taking -tasc -test/accommodations -for -disabilities/ ? testing accommodations due to a disability No Yes 1. Have you applied for TASC ™ 2. Check the status of your accommodation re quest : . I applied for testing accommodations but have not received a decision from DRC d. applied for testing accommodations to DRC and my request was denie I by DRC. approved applied for testing accommodations and my request was I er must be included with this application. A copy of the TASC Accommodations Approval Lett Continued (Page 6 of 6) Test Assessing Secondary Completion (TASC™) Application - (6 )

7 Print and mail this completed application to the Test Center where you would like to test. First Name ( Legal Name): Name): Legal Last Name ( Middle Initial Applicant Signature and Certification for All First Time and Returning Applicants (18 years and older) I understand that my eligibility for TASC™ testing will be determined based on the information contained in this application, and on any enclosed documentation. I certify that I do not hold a high school diploma or high school equivalency diploma recognized in the United States. I further certify that I am not involved with any instruction of students who are preparing to take the TASC™ Test. I certify that the information with this application and any attachments is complete and accurate to the best of my knowledge. included I further agree that i f it is determined that I intentionally gave false information on my application that my TASC™ testing scores can be invalidated. I further authorize DRC to score each subtest and share the results of my testing information with the New York State Ed ucation Department, the Test Center where I tested and the high school equivalency preparation program (if applicable) that I attended. I understand that if I provide a valid email address, question 7 on page 4 of this application, that I will be able to unofficial view my TASC™ test scores on the DRC TASC™ Test State Portal. I understand that I have reached the “maximum compulsory school attendance age” if I am sixteen (16), or seventeen (17) in some that I must document regions of New York State, and age eligibility criteria if I am under age nineteen (19) by the first day of the test. By signing below, I agree to the items and conditions , in this section of the application. , as noted above DATE: _____ /______ /______ APPLICANT SIGNATURE: _ ______________________________________________ Parent or Guardian Signature (Required for all Test Applicants under the age of 18) I am verifying that the information contained in the application for my son or daughter, for whom I am the legal parent/guardian, is true to the best of my knowledge. I give permission for my son or daughter to take the TASC™ test, DRC to score each subtest, and to share the results with th e New York State Education Department, the Test Center where my son or daughter tested and the high school equivalency preparation program (if applicable) that he or she submitted. I understand that if my son or daughter provides a valid email address, question 7 on page 4 of this application, he or she w ill be able unofficial to view their TASC™ test scores on the DRC TASC™ Test State Portal. ve I understand that my son or daughter mus reached the “maximum compulsory school attendance age” if sixteen (16), or t ha age eligibility criteria if he or she is seventeen (17) in some regions of New York State, and that my son or daughter must document under age nineteen (19) on the first day of the test. By signing below, I agree to the items and conditions as noted above, in this section of the application. PARENT OR GUARDIAN SIGNATURE: _______________________________________________ DATE: _____ /______ /______ APPLICATION END of ) (7

8 General Information on New York State TASC™ Processes : ttendance) y School Age A nde r Age 19 (Maximum C ompulsor Applicants u Applicant f testing a ay o ) on the first d 17 eventeen ( r s 16) o e sixteen ( re ag s who a o meet “maximum re required t compulsory school a ttendance a ge” r equirements. Applicants r each “maximum c ompulsory school attendance In Ne 30). nded (June s e ge ha f a ars o which they turn sixteen (16) ye ar in ye chool ork City, and e” when the s ag w Y maximum c districts i n N ork State, applicants r each “ ther publi ompulsory s chool at tendance ew Y c-school n some o i ye n which they turn seventeen (17) ye ars o f a ge ha chool nded (June 3 0). age” w hen the s s e ar i teen ho a re s ix attendance a m compulsory school In addition to m equirements, applicants w ng “maximu eeti ge” r ghteen ( r ei 17) o eventeen ( (16), s f a ears o 18) y eligibility cr ay o f t esting must m eet a ge irst d iteria and ge on the f ail the a ppropriate attachments t o t he T est C ente r with t his application . Applicants age nin eteen are r equired to m ed to m ge e ligibility requirements. (19) and over do not ne eet a ccommodations: Testing A Applicant ccommodations if esting a s may request t o ishing t pplicants w cumented disability. A they have a do ail cumentation ( nd supporting do request a their edical ust m ccommodations m request t esting a nd/or m IEP a documentation to D formation s n. For in nd decisio eview a RC f or r ee: https://tasctest.com/demo - -home/test ccommodations, a esting a pproved for t . If a ust -for -test/accommodations takers/taking -tasc pplicants m -disabilities provide the Tes c he TASC A t Center t . Once Lette g scheduled to t commodations A est e bein r befor pproval g he same t applicants a re a pproved for t esting a estin ccommodations, t hey do not ne ed to r eapply for t is n c letter i pproval ccommodations A portant to keep a copy of the A is very im ase it accommodations , but it o retest. necessary t After Ap plying: f r esidency, roof o pplication, p this a bmit u pplicants s Once a nd testing if applicable) a ttachment ( eligibility a age omputer r C icket fo esting t ll receive a t , they wi est Center ) to th applicable e T accommodation a pproval le tter (if Based testing (CBT) or an admissions notice for Pa ndi per Based testing (PBT) which i ocation, testing cates the l ™ ed TASC . date(s), and testi ng times of the schedul admission n ring their f 2) forms o wo ( th t ogether wi enter t he Test C t to t esting ticke r t otice o Applicants m ust b n e ay o identification (one w ith a cu rrent p hoto) o ons an ach d f t esting and m ust f ollow a ll testing rules, regulati d testing po Test C licies a nd procedures e stablished by the enter. ubtests ach of t hese s ust t or cores f . The unofficial s Applicants m hen scores e ak e each scheduled subtest. D RC t each subtest c alid email eviously provided a v they have pr RC student portal if an be viewed by examinees o n the D ranscript) r t address . They may also c heck t he NY SED S tatus R eport t o de termine if an actual do cument ( diploma o h school e quivale btained a hig ncy was pr oduced. The S tatus R eport pr ovides da ta o n whethe r an examinee ha s o diploma. (8)

9 A Review of New York State TASC™ Policies -test -hsetasc http://www.acces.nysed.gov/what tion at: Informa Applicants m nd m mplete a ust co The TASC is offered in either English or Spanish. n in the applicatio ail this packet to the Test Center where they wish to take Formats include: English or Spanish print, Large Print, Audio/CD and Braille. the TASC™ . Applicants m Examinees are not permitted to retest on the same ust be t or a residents f or k State New Y test form during a calendar year. least thirty (30) days by the first day of testing i n order to take the TASC™. Examinees may take the TASC™ a maximum of An examinee needs to pass all five (5) subtests to earn three (3) t imes in a c alendar y diploma. a New York State High School Equivalency ear. The subtests include: Writing; Social Studies; Science; nd Mathematics. Reading; a There is also an alternate pathway, the Regents HSE Exam pathway, for those who have previously passed one - or more Regents exams, which can be used in conjunction with TASC subtests. Attachment R information link: http://www.acces.nysed.gov/hse/regents -exam -hse The minimum passing score for each TASC™ subtest is Examinees must wait a minimum of sixty (60) calendar days from the fist date of testing to retest. 500. - Passing GED® 2003 Applicants who are sixteen (16) or seventeen (17) 2013 English and passing GED® years of age must reach “maximum compulsory school 2004- 2013 Spanish or French test scores of 410 or attendance age” by the first day of testing. e used toward earning a New York State higher can b High School Equivalency Diploma. In addition to reaching “maximum compulsory school A test session is generally administered within an eight (8) calendar day period. attendance age,” applicants who are sixteen (16) or the first day of testing on seventeen (17) years of ago must meet additional age eligibility criteria. Although applicants who are eighteen (18) years of age Applicants must send all requests for Testing Accommodations to DRC for review and a decision. have already met “maximum compulsory school -home/test till See: - attendance age” by the first day of testing, they s https://tasctest.com/demo need to meet age eligibility criteria. -for -test/accommodations -tasc takers/taking - disabilities/ (9 )

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