Fillable 202122 GRE General Test Authorization Voucher Request Form (ETS)

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202122 GRE General Test Authorization Voucher Request Form (ETS)

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The 202122 GRE General Test Authorization Voucher Request Form (ETS) form is 2 pages long and contains:

  • 1 signature
  • 1 check-box
  • 24 other fields

Country of origin: US
File type: PDF

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_________________________________________________________________________________________________________________________________________
2021–22 GRE
®
General Test Authorization Voucher Request Form
You can register for the GRE
®
General Test online with a credit/debit card in your ETS account at
www.ets.org/mygre. Use this form ONLY if you are paying with a paper check or money order.
• Complete pages 1 and 2.
• DO NOT use this form if you are requesting testing accommodations for disabilities or health-related
needs. Visit www.ets.org/gre/disabilities.
• DO NOT SEND CASH. Remittance must be payable to ETS-GRE.
Mail to:
ETS-GRE
Box 382013
Pittsburgh, PA 15251-8013 USA
*Required Field
*ETS ID (8 characters): Your ETS ID is located on the My
GRE home page of your ETS Account.
*First (Given) Name
(as on photo ID document; up to 24 characters):
Middle Initial
*Last (Family) Name
(as on photo ID document; up to 32 characters):
*Address Line 1 (up to 32 characters):
*Address Line 2 (up to 32 characters):
*City
(up to 25 characters):
*State/Province/
Territory:
*Postal Code
(up to 9 characters):
*Country Code
(Refer to
www.ets.org/gre/countrycode):
*Primary Phone (include Area Code):
Alternate Phone (include Area Code):
*Date of Birth (MM-DD-YYYY):
*Gender (M/F):
U.S. Social Security Number:
*Email Address (up to 45 characters):
(continued on page 2)
2
ORDER INFORMATION
DIRECTIONS: Fill in the dollar amounts for all items that apply.
Make remittance payable to ETS-GRE. DO NOT SEND CASH.
Voucher/Promotional Code (16 characters): If using
a voucher/promotional code, enter below.
Include country and related test fee where the test will be
taken. Fees and terms relating to fees and payment are
available at www.ets.org/gre/fees.
Country: ___________________________________________
Test Fee: .................................................................... ______ US$
Standby Registration .............................................. ______ US$
Subtotal .................................................................... ______ US$
Voucher/Promotional Value
(subtract from subtotal, if applicable) ............................... ______ US$
TOTAL AMOUNT ENCLOSED ................................... ______ US$
If you send a check to us, you authorize ETS to convert the check into an electronic fund transfer. Please be aware that your
bank account may be debited as soon as the same day we receive your payment and you will no longer receive a canceled
check. If you do not have sufficient funds in your account, an additional service fee of US$20
will be added to your account.
☐ I understand and acknowledge the terms and conditions outlined in the Acknowledgment attached on pages 3–5 of
this form.
I hereby agree to the conditions set forth in the 2021–22 GRE
®
Information Bulletin and on the GRE website, specifically
those concerning test administration, payment of fees, the reporting of scores and the confidentiality of test
questions. I certify that I am the person who will take the test at the center and whose name and address appear on
this form.
Signature: ______________________________________________________________ Date: ___________________________________
Copyright © 2021 by ETS. All rights reserved. ETS, the ETS logo, and GRE are registered trademarks of
ETS in the United States and other countries.
click to sign
signature
click to edit
3
ACKNOWLEDGMENT
This Acknowledgment, including the Privacy Notice at www.ets.org/legal/privacy, contains the terms and conditions between you and Educational
Testing Service (“ETS,” “we,” “us,” “our”) regarding the ETS test you are now registering for and/or the testing products and services you are now
requesting (these are together referred to as “Testing Services”). It applies to all actions you take regarding the Testing Services, including
creating an online account, providing survey information regarding a test that you take, requesting one of our services relating to the test and
completing a test or product order and providing payment information.
Personal Information
In registering for the Testing Services, you acknowledge and agree that we have the right to obtain, collect, store, use, disclose (including to public
authorities and score recipients), extract and transmit (collectively “use”) the personal information you provide, including your full name, home
address, email address, telephone number, social security or similar number, passport number, national ID number, gender, nationality, age,
date of birth, responses to other background information questions, test administration date and details, payment information and how you
specifically use our website. This also includes our use of biometric data (including fingerprints, audio recordings, facial images and video files)
provided by you in the course of your registering for and participating in the Testing Services. All of the above data is referred to as “Personal
Information.” Which Personal Information we hold, how we use it and how long we hold it for may be subject to legal limitations in the
jurisdiction in which you receive the Testing Services. ETS strives to meet these legal requirements, and further information on how we do so is
provided below.
How We Use Your Personal Information
We use your Personal Information to:
• complete any registration, purchases or other transactions you request
• improve our products and services, and identify, develop and offer new or expanded products and services
• improve and personalize your experience on the website, and customize the content and/or format of the pages you visit
• subject to your opting-in (see below), notify you about updates, products, services and/or special offers from ETS, its affiliates and
selected third parties
• ask you to participate in brief surveys or provide other information
• generate aggregate statistical studies and conduct research ourselves or jointly with others related to our products and services and the
use of our website
If you agree (or have agreed) under other agreements with ETS that we may use your Personal Information in additional ways, those other
agreements will not be limited by this separate Acknowledgment.
International Transfer
ETS, its website, and its servers are located in the United States. Therefore, your information, including Personal Information, will be transferred
from your location to the United States in accordance with applicable laws. It may also be transferred directly from your location or via the U.S.
to other countries who provide processing services to ETS, all at the direction of ETS and in accordance with applicable laws. In accepting this
Acknowledgment, you are agreeing to cross-border transfers of your information, including your Personal Information. If you do not agree to
these cross-border transfers, then you should refrain from using the website. You may have a right under applicable law to revoke your consent
to the international transfer of your Personal Information. If you do so, we are unlikely to be able to continue providing the Testing Services to
you.
Third Party Disclosure
We communicate your Personal Information to certain third parties, within the jurisdiction of your location and elsewhere, with whom we have a
direct or indirect business or contract relationship in order to provide you with the Testing Services you have requested. These third parties
assist with various aspects of the delivery of the Testing Services, including security services and score distribution services.
Your Rights
In some instances, under applicable laws, you have the right to withdraw your consent and require us to delete your Personal Information
should the lawful purposes for which we hold it cease. You may also request that we correct your Personal Information if it is incorrect,
inaccurate, misleading or incomplete. To protect your privacy and security, we will take reasonable steps to verify your identity before granting
access or making corrections.
4
ACKNOWLEDGMENT (continued)
If required under applicable laws, at your request and on satisfactory proof of identity (as determined by ETS), we will provide you (i)
confirmation that we hold your Personal Information, (ii) details or a description of the Personal Information we hold in an intelligible f
orm; (iii)
information of how we came to hold the Personal Information, the purposes for which we are using it, and in some cases the methods and logic
we
use in processing the Personal Information; (iv) further corporate information regarding ETS and, in some circumstances, the other corporate
entities who may process the Personal Information on behalf of ETS.
To r
equest any of the above actions, please contact us at: Educational Testing Service, 660 Rosedale Road, Princeton, NJ 08541, USA, email:
etsinfo@ets.org
.
You may also have the right under certain applicable laws to complain to a regulatory authority in your country if you believe we have not
processed your Personal Information in compliance with applicable laws.
Further Communications
We ask you to provide your contact details, including email address, telephone and mobile phone details. We use this information so that we can
quickly provide you with information (principally by way of email, telephone, SMS or other electronic means) regarding the Testing Services you
have requested and to provide you with information about other testing products and services (which we will do in accordance with applicable
laws). When you receive communications from us about other testing products and services, you will have the opportunity of subsequently
opting-out of receiving these, and our communications will contain instructions on how to do so. Remember, however, that we may still send
emails or call you in order to provide the Testing Service you have purchased or otherwise requested from us.
Governing Law
You agree that this Acknowledgment will be governed by and construed in accordance with the laws of the United States and the State of New
Jersey, without regard to principles of conflict of laws.
Additional Information
This paragraph containing additional information is of general application, but it is also provided for purposes of the EU General Data Protection
Regulation when it comes into force (to the extent the Regulation is applicable to you in the context of the Testing Services):
ETS Corporate Details (including contact details): Educational Testing Service, 660 Rosedale Road, Princeton, NJ 08541, USA, email:
etsinfo@ets.org
.
Purpose and Legal Basis for Processing: To provide tests and testing services as requested, including processing for the administration of tests,
such as marking and score reporting to test takers and nominated score recipients.
Legitimate Interests relied upon: ETS requires your Personal Information for purposes of administering educational tests and providing these
tests in a secure manner so that test takers receive accurate results and test qualifications are recognized by intended score recipients.
International Transfers: Data will be transferred to data processors engaged by ETS in various jurisdictions outside of the EEA, depending on the
particular Testing Services requested. These transfers are made in accordance with the acknowledgment you have given above and
intercompany and third-party transfer agreements, in accordance with applicable laws.
Personal Information Retention: Personal Information is generally held for five years from the date of its submission. This period may be
extended by ETS if the score for the Testing Service you require remains valid for a longer period (which information is usually contained in your
testing result information), if the Testing Service you have requested is being reviewed or if our legitimate interest in retaining your Personal
Information remains in place. It also may be shorter if we no longer require your Personal Information (for example, if you have expressed
interest in a test but have not taken one). You may contact us at etsinfo@ets.org
if you require further information.
Data Subject Rights: In addition to the rights described above, you may have data portability rights. For security reasons, most testing
organizations will require that Personal Information be obtained directly from you and this may limit the usefulness of your data portability
rights.
Supervisory Body: Please contact the national data processing authority in the jurisdiction in which you receive the Testing Services.
For Hong Kong residents only: Subject to applicable laws regarding our use of your Personal Information, we will not use your Personal
Information if we do not reasonably believe that such use is in your interests. In order for us to supply you with the Testing Services, you must
supply us with your Personal Information to complete any registration, purchase or other transaction you request online and/or perform any of
our other contractual obligations to you which requires us to have the Personal Information.
5
ACKNOWLEDGMENT (continued)
For Australian residents only: Please be informed that if you agree to the overseas disclosure of the information or transfer of your data outside of
Australia, ETS and its affiliates will not be required to take reasonable steps to ensure that ETS or its affiliates’ use of such data outside of
Australia does not breach the Australian Privacy Principles.
For Canadian residents only: This is the notification that ETS is required to provide to Canadian residents. Please see above regarding International
Data Transfers. Where we transfer Personal Data to third parties we contractually require third parties to have a written procedures in place that
comply with the requirements of the applicable privacy laws in Canada.
For Singapore residents only: In connection with the transfer of your Personal Information outside of Singapore, ETS believes that the laws of the
recipient country of your Personal Information will provide a standard of protection comparable to the applicable laws of Singapore.
Contact Information
If you have questions or requests concerning our use of your Personal Information, you should contact: etsinfo@ets.org
.
By indicating “Accept,” you expressly and voluntarily acknowledge and agree to the terms and conditions above, particularly those relating to our
use of biometric data and the international transfer of Personal Information.
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202122 GRE General Test Authorization Voucher Request Form (ETS)

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Completed 7 July 2021

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