Tasc Application Attachment A Form – Fill Out and Use This PDF

ATTACHMENT A

The University of the State of New York

THE STATE EDUCATION DEPARTMENT

High School Equivalency (HSE) Office

(518) 474-5906

APPLICATION FOR TASC™ TESTING (2016)

(Must be completed each time an applicant applies to test)

Applicant must provide a response to each item and sign the application in blue ink.

It is recommended that all applicants review TASC™ test materials before taking the test.

For a listing of free HSE Preparation Programs in your area go to: http://www.acces.nysed.gov/hse/hse‐prep‐programs‐maps

Send this application to the local test center where you wish to test.

You can find a local test center on our website: http://www.acces.nysed.gov/hse/hse‐testing‐maps

DO NOT SEND COMPLETED APPLICATION TO THE NYSED HSE OFFICE.

A. High School Equivalency Testing History*

1.	Have you ever taken a TASC™ Test (2014‐present) in another State?				Yes	No
2.	Have you ever taken the TASC™ Test (2014‐present) in New York State?				Yes	No
3.	Have you ever taken the GED® Test (2002‐2013) in New York State?				Yes	No
4.	What name did you use the last time you tested in New York State?
	First Name	Middle Initial	Last Name
5.	Name of Test Center Where You Took Your Last TASC™ or GED® Test			Date When the Last Test Was Taken
				/	/

If you answered “yes” to questions 2 or 3, it is recommended that you provide a copy of your latest failure notice and mail a copy of it with this application to the testing center.

B. Residency Requirements to take the TASC™ Test in New York State*

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Application for TASC™ testing (2016)

Attachment A (continued)

C. Maximum Compulsory School Attendance Age*

D. New York State Age Eligibility Requirements for 17 or 18 year old applicants*

In addition to meeting the “maximum compulsory school attendance age” requirement (17 year olds only), all 17 and 18 year old applicants must meet one (1) of the ten (10) eligibility criteria listed below in order to test. An applicant who meets any of these criteria must mail in the required proof of eligibility with this application to the Test Center. For copies of these required attachments

go to: http://www.acces.nysed.gov/hse/high‐school‐equivalency‐hse‐forms

8.	Age Eligibility Criteria Description – for 17 or 18 year old applicants	Required Proof of Eligibility
	Applicant is foreign born and has never attended K‐12 schools in the United States. Applicant	Attachment F
	must submit a copy of his or her visa or passport showing initial arrival date in the United	(Must be notarized)
	States.
	One year has passed since the applicant was last legally able to leave high school and last	Attachment B
	enrolled in a full‐time high school program of instruction.
	Applicant was a member of a high school class that has already graduated.	Attachment B
	Applicant is enrolled in an Alternative High School Equivalency Preparation (ASHEP) Program.	T‐TAF
	Applicant has been conditionally accepted into the United States Armed Forces.	Attachment D
	Applicant has been conditionally accepted into a college, university or post‐secondary	Attachment D
	institution.
	Applicant is currently enrolled in a Job Corps Program.	Attachment D
	Applicant is incarcerated or institutionalized.	Attachment E
	Applicant is an adjudicated youth under the direction of a prison, jail, detention center, court,	Attachment E
	parole, or probation office.
	Applicant was home schooled.	Attachment B

E. New York State Age Eligibility Requirements for 16 year old applicants*

In addition to meeting the “maximum compulsory school attendance age” requirement, all 16 year old applicants must meet one (1) of the four (4) eligibility criteria listed below in order to test. An applicant who meets any of these criteria must mail in the required proof of eligibility with this application to the test center. For copies of these required attachments go to:

http://www.acces.nysed.gov/hse/high‐school‐equivalency‐hse‐forms

8.	Age Eligibility Criteria Description – for 16 year old applicants	Required Proof of Eligibility
	Applicant is enrolled in an Alternative High School Equivalency Preparation (ASHEP) Program.	T‐TAF
	Applicant has been accepted into the United States Armed Forces.	Attachment D
	Applicant has been accepted into a college, university or post‐secondary institution.	Attachment D
	Applicant was home schooled.	Attachment B

F. New York State Age Eligibility Requirements for applicants 19 years or older

In New York State an applicant must be nineteen (19) years of age or older by the day of testing in order to take the TASC™ Test without having to supply age eligibility proof to the test center.

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	Application for TASC™ testing (2016)	Attachment A (continued)
J. Testing Accommodations
27.	Have you applied for TASC™ testing accommodations due to a disability?	Yes	No
	If you answered “No” to item number 27, go to item #30 or item #31 depending upon your age.
	If you answered “Yes” to item number 27, go to item #28.
28.	Check the status of your accommodations request.
	I applied for testing accommodations, but I have not received a decision from DRC/CTB.
	I applied for testing accommodations to DRC/CTB and my request was not approved.
	I applied for testing accommodations and my request was approved by DRC/CTB.
	.
	You must enclose a copy of your testing accommodations approval letter with this application.
29.	If you were approved for testing accommodations, please indicate the approved form type.
	English Print Spanish Print English Audio Spanish Audio English Braille	Spanish Braille	Large Print

K. Applicant Signature and Certification for All First Time and Returning Applicants

By signing below I agree to the terms and conditions noted above in Question 30.

EXAMINEE SIGNATURE _______________________________________________________ DATE _____/_____/______

L. Parent or Guardian Signature (Required for all First‐Time and Returning Applicants under the age of 18)

By signing below I agree to the terms and conditions noted above in Question 31.

PARENT OR GUARDIAN SIGNATURE ___________________________________________ DATE ____/_____/______

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03/31/2016