Fillable Bulletin Supplement 202122 GRE (ETS)

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2021–22 GRE

Bulletin Supplement

for Test Takers with Disabilities

or Health-related Needs

This Supplement contains procedures and forms for requesting

accommodations for the GRE

General Test and/or the GRE

Subject Tests.

It should be used together with the 2021–22 GRE

Information Bulletin.

www.ets.org/gre/disabilities

145740-145740 • UNLWEB521

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

CONTACT INFORMATION

All questions related to accommodations should be directed to ETS Disability Services.

ETS Disability Services

Phone: 1-866-387-8602 (toll-free in the U.S., U.S. Virgin Islands, Puerto Rico, and Canada)

1-609-771-7780 (all other locations)

Monday–Friday 8:30 a.m.–5 p.m. U.S. Eastern Time (New York)

General Email Inquiries:

stassd@ets.org

Requests for Testing Accommodations:

disability.reg@ets.org

Mail: ETS Disability Services

PO Box 6054

Princeton, NJ 08541-6054

Courier Service:

ETS Disability Services

225 Phillips Boulevard

Ewing, NJ 08628-1426

ETS, the ETS logo, MEASURING THE POWER OF LEARNING, GRE, TOEFL, PRAXIS and HiSET are registered trademarks of

Educational Testing Service (ETS) in the United States and other countries. All other trademarks are the property of their respective owners.

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

CONTENTS

Contact Information ............................................................................................................................ 2

ETS Disability Services .................................................................................................................... 2

General Information ............................................................................................................................ 4

Using Previously Approved Accommodations .................................................................................. 4

Reduced-distraction Setting ............................................................................................................. 5

Pre-approved Personal Items

......................................................................................................... 5

How to Request Accommodations .................................................................................................... 5

Steps to Request Accommodations ................................................................................................. 5

Step 1: Complete the Testing Accommodations Request Form

..................................................... 5

Part I — Applicant Information ........................................................................................................ 5

Part II — Accommodations Requested ............................................................................................ 6

Part III — Certication of Eligibility: Accommodations History ......................................................... 7

Step 2: Complete GRE Test Authorization Request Form for Test Takers with Disabilities

or Health-related Needs (if not submitting your materials online)

................................................ 7

Step 3: Gather Your Disability Documentation ................................................................................. 7

Step 4: Submit Your Completed Forms and Documentation to ETS Disability Services ............. 9

Changing or Canceling Your Test .................................................................................................... 10

Test Preparation ................................................................................................................................ 10

Score Reporting ................................................................................................................................. 10

FORMS

GRE

TESTING ACCOMMODATIONS REQUEST FORM .

.................................................................................................................................................11

................................................................11

Part I — Applicant Information ........................................................................................................11

Part II — Accommodations Requested .......................................................................................... 16

Part III — Certication of Eligibility: Accommodations History ....................................................... 18

2021–22 GRE

Test Authorization Request Form for Test Takers with Disabilities or

Health-related Needs ......................................................................................................................... 23

Acknowledgment ............................................................................................................................... 25

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

GENERAL INFORMATION

ETS is committed to serving test takers with disabilities or health-related needs by providing reasonable

accommodations that are appropriate given the purpose of the test.

While many test takers with disabilities successfully take a GRE

test with appropriate accommodations, some

test takers with disabilities may want to ask their prospective institution or fellowship sponsor whether it is

willing to waive the test requirement and consider their application based on other information.

Important: Test takers requesting accommodations MUST complete a Testing Accommodations Request Form

and submit it to ETS Disability Services. The form may be submitted online, via email, mail or courier service.

We strongly encourage using the convenient online registration system. You must submit your request and

have your accommodations approved by ETS Disability Services before your GRE test may be scheduled.

Accommodations cannot be applied to a test that has already been scheduled.

Submit your request as early as possible. Documentation review takes approximately four to six weeks once

your request and complete paperwork have been received at ETS. If additional documentation is requested,

it may be approximately another two to four weeks from the time the new documentation is received until

the review is complete. ETS is committed to producing alternate test formats as quickly as possible; however,

production times may vary, especially if you are taking a GRE Subject Test.

Information about GRE program policies, tests offered, test dates, fees and payment policies, identication (ID)

requirements, testing procedures and score reporting information is available in the GRE

Information Bulletin

and on the GRE website at www.ets.org/gre. It is recommended you review this information prior to requesting

accommodations.

To submit your accommodations request online, you will need to create an ETS account at www.ets.org/mygre.

In your ETS account you may upload documentation and indicate your preferred test date and location. You

may also view your approved accommodations and test appointments. In addition, if you are approved for

extended test time, extra breaks, screen magnication and/or selectable background and foreground colors, you

may also self-schedule your test online through your ETS account. If you are requesting and are approved for

accommodations other than the four listed above, you cannot schedule your test online. Your approval letter

will provide instructions for scheduling your test.

Using Previously Approved Accommodations

If you were previously approved for accommodations on a GRE test, review your approval letter to determine

if your accommodations approval is still current. If your accommodations have not expired, you may register

following the directions on your letter.

If you are registering for a paper-based test (GRE Subject Tests), complete Parts I and II of the

Accommodations Request Form and registration form even if you are requesting accommodations identical to

those approved for you by ETS within the last two years.

If you have received accommodations from ETS for another test (for example, the TOEFL

test, a Praxis

test,

or a School Leadership Series assessment) and your documentation is still current, you may request the same

accommodations for a GRE test during the 2021–22 testing year without providing disability documentation.

The accommodations ETS previously approved for you will be approved again if they are appropriate for the

current test.

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

Reduced-distraction Setting

Many test takers request a reduced-distraction setting. The testing centers are designed to have minimal

distractions with each test taker assigned to an individual carrel with earplugs or headphones available upon

request to further reduce environmental noise.

Pre-approved Personal Items

Certain items are allowed in the testing area without prior approval. These include, but are not limited

to, bandages, spinal cord stimulators, foot stool, lumbar support cushion, service animals and hearing

aids/cochlear implant. However, if your hearing aids or cochlear implant have Bluetooth capabilities,

accommodations must be requested. The full list of pre-approved personal items for use at test centers is

available at www.ets.org/disabilities/prometric.

If you wear an insulin pump, you do not need to request accommodations unless your pump consists of two

pieces (the pump which is attached to your body plus the transmitter used to program the pump) or your

pump is especially noisy. If the pump cannot be silenced and is likely to disturb other test takers, requesting

accommodations is a good idea so you may be scheduled in a separate room. A continuous glucose monitor

attached to your pump does not require prior approval; however, if you wish to have your glucose test kit in the

testing area, you must request accommodations.

HOW TO REQUEST ACCOMMODATIONS

Steps to Request Accommodations

To request accommodations for a GRE test, follow the steps below:

1. Complete the Testing Accommodations Request Form.

2. Complete the GRE Test Authorization Request Form for Test Takers with Disabilities or

Health-related Needs (if not submitting your materials online).

3. Gather your disability documentation.

4. Submit completed forms.

Detailed information regarding each of these steps is provided in this Supplement.

STEP 1: COMPLETE THE TESTING ACCOMMODATIONS REQUEST FORM

Complete the Testing Accommodations Request Form on pages 11–22 in this Supplement or access and

complete the form in your ETS account at www.ets.org/mygre.

Part I — Applicant Information

Complete this section and sign the Applicant’s Verication Statement even if you are requesting

accommodations identical to those approved for you by ETS within the last two years.

GENERAL INFORMATION (cont.)

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

Part II — Accommodations Requested

Complete this section even if you are requesting accommodations identical to those approved for you by

ETS within the last two years. If you are requesting accommodations other than those listed in Part II,

you must describe them under “Other Accommodations.”

Accommodations for Health-related Needs

Health-related needs are most commonly those affecting digestion, immune function, respiration,

circulation, endocrine functions, etc., and frequently require only minor accommodations.

Documented health needs include conditions such as diabetes, Crohn’s disease and chronic pain. Minor

accommodations include but are not limited to: extra breaks for medication, snacks, beverages or glucose

testing materials that are necessary during the test session.

Documentation for health-related needs should include a letter of support from a medical doctor or

other qualied professional stating the nature of the condition and the rationale for the requested

accommodation(s). Please note, handwritten documentation or a note on a prescription pad is not

acceptable.

Commonly Requested Accommodations

• Extended Test Time (all tests are timed)

$ 25 percent (time and one-quarter) or 50 percent (time and one-half) or 100 percent (double time)

• Extra Breaks — The testing clock stops for breaks and does not affect your testing time. Breaks may

be used for medication, snacks, trips to the restroom, etc. Some disabilities, by their nature, result in

fatigue, the need for rest, and/or restroom breaks while not impacting the actual test taking. In these

cases, extra breaks may be more appropriate than extended test time.

• Accommodations for Computer-delivered General Test Only

$ Screen magnication

$ Selectable background and foreground colors

$ JAWS screen reader (only for applicants who are blind, legally blind, or have low vision)

• Assistance

$ Human reader (Only at test centers)

$ Human scribe (Only at test centers)

$ Assistance for spoken directions (only for applicants who are deaf or hard-of-hearing) (Only at

test centers)

• Oral interpreter

• Sign language interpreter

$ Assistance for note taking (only for applicants who are blind, legally blind, or have low vision)

• Braille slate and stylus

• Perkins brailler

STEP 1: COMPLETE THE TESTING ACCOMMODATIONS REQUEST FORM (cont.)

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

• Alternate Test Formats

$ Braille

$ Large-print test book

$ Large-print answer sheet (applies to the GRE Subject tests only)

$ Recorded audio

$ Recorded audio with tactile gure supplement (only applicants who are blind, legally blind, or

have low vision)

$ Recorded audio with large-print gure supplement (only applicants who are blind, legally blind,

or have low vision)

Part III — Certication of Eligibility: Accommodations History

All applicants are encouraged to submit Part III — Certication of Eligibility: Accommodations History

form which serves two distinct purposes:

• To provide verication of an individual’s use of accommodations either in college or in the workplace

• As a shortcut for approval of certain specic accommodations for particular disabilities

STEP 2: COMPLETE THE GRE TEST AUTHORIZATION REQUEST FORM FOR

TEST TAKERS WITH DISABILITIES OR HEALTH-RELATED NEEDS (IF NOT

SUBMITTING YOUR MATERIALS ONLINE)

If you plan to submit your materials to ETS Disability Services by email or mail instead of online at

www.ets.org/mygre, complete the GRE Test Authorization Request Form for Test Takers with Disabilities

or Health-related Needs form on pages 23–24 in this Supplement.

STEP 3: GATHER YOUR DISABILITY DOCUMENTATION

You must submit disability documentation if any of the following are true:

• You are requesting accommodations greater than 50 percent extended test time (time and one-half)

and/or extra breaks.

• You indicate in Part I of the Testing Accommodations Request Form you have a medical condition, or

you check “Other” under “Nature of your disability.”

• You were rst diagnosed with a disability within the past 12 months.

• You are requesting accommodations different from those ETS approved for you within the last two

years.

• You have not previously used the accommodations being requested.

• You have a sensory disability and your accommodations request does NOT match the specications

which follow on the next page.

• You are unable to submit a valid Part III — Certication of Eligibility: Accommodations History form.

STEP 1: COMPLETE THE TESTING ACCOMMODATIONS REQUEST FORM (cont.)

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

DO NOT send documentation if you are not required to do so. Submitting unrequired documentation

will delay the review process. An Individualized Education Program (IEP) or 504 Plan which provides a

history of disability and accommodations use may be helpful; however, an IEP or 504 Plan alone is not

sufcient information for accommodation decision making. For more information regarding documentation

guidelines, please visit www.ets.org/disabilites.

If you have low vision or some other condition which affects visual functioning, such as an eye coordination

disorder, refer to the “Guidelines for Documentation of Blindness and Low Vision in Adolescents and

Adults” online at https://www.ets.org/disabilities/documentation/ and submit your documentation. If you

are blind or legally blind, you do NOT need to submit documentation if you are submitting a Certication

of Eligibility: Accommodations History form and are requesting only accommodations from the list below.

• Screen magnication

• Selectable background and foreground colors

• Braille

• Large print (test book and/or answer sheet)

• Recorded audio

• Human reader

• Human scribe

• Braille slate and stylus for note-taking only

• Perkins brailler for note-taking only

• 50 percent extended test time (time and one-half) or less

• Extra breaks

If you are blind or legally blind, a request for 100 percent extended test time (double time) does not require

documentation if you are submitting a Part III — Certication of Eligibility: Accommodations History

form and you are requesting braille, a human reader or recorded audio.

If you are deaf or hard-of-hearing, you do NOT need to submit documentation if you are submitting

a Part III — Certication of Eligibility: Accommodations History form and are requesting only

accommodations from the list below.

• 50 percent extended test time (time and one-half) or less

• Extra breaks

• Sign language interpreter (for check-in assistance and spoken directions only)

• Oral interpreter (for check-in assistance and spoken directions only)

STEP 3: GATHER YOUR DISABILITY DOCUMENTATION (cont.)

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

STEP 4: SUBMIT YOUR COMPLETED FORMS AND DOCUMENTATION TO ETS

DISABILITY SERVICES

Requests for testing accommodations may be submitted online or via email, mail or courier service. We

strongly encourage using the convenient online registration system. Be sure to include the appropriate

documents with your submission. An incomplete application will cause a delay in processing your request.

Submitting Your Material Online in Your ETS Account

You may submit materials online through your ETS account at www.ets.org/mygre. Once signed in, select

“Accommodation Status/New Request” under the “Test Takers with Disabilities or Health-related Needs”

section on the home page and follow the instructions.

Submitting Your Material by Email

Be sure to attach the following items with your email message:

□ Completed Testing Accommodations Request Form

□ Completed GRE Test Authorization Request Form for Test Takers with Disabilities or

Health-related Needs

□ Disability documentation (if required)

Requests for accommodations should be sent to disability.reg@ets.org.

Please note: Do not include credit card information with your email or mail (Payment is needed at time of

scheduling). Once your application has been received at ETS, you will receive an email with instructions

regarding payment options.

Submitting Your Material by Mail or Courier Service

Be sure to include the following with your request:

□ Completed Testing Accommodations Request Form

□ Completed GRE Test Authorization Request Form for Test Takers with Disabilities or

Health-related Needs

□ Disability documentation (if required)

□ Appropriate GRE test fee (only if registering for a GRE Subject Test)

Mail your material to the appropriate address below.

Mail

ETS Disability Services

PO Box 6054

Princeton, NJ 08541-6054

U.S.A.

Courier Service

ETS Disability Services

225 Phillips Boulevard

Ewing, NJ 08628-1426

U.S.A.

Once your accommodations have been appr

oved, you will receive an email from ETS Disability Services

with instructions regarding how to register for the GRE test.

Regardless of how you submit your material, ETS Disability Services will contact you via email regarding

your application.

2021–22 GRE Bulletin Supplement for Test Takers with Disabilities or Health-related Needs

CHANGING OR CANCELING YOUR TEST

Policies for changing or canceling your test are included in the GRE

Information Bulletin and on the

GRE website at www.ets.org/gre.

If you are scheduled to take a computer-delivered test at a Prometric

center, you may change or cancel

your test by calling Prometric at 1-800-967-1139. For all other computer-delivered testing locations

(including at home) or paper-delivered testing sites, contact ETS Disability Services (refer to page 2).

TEST PREPARATION

Information about test preparation materials for the GRE

General Test is available at

www.ets.org/gre/prepare. Information about test preparation for the GRE

Subject Tests is available at

www.ets.org/gre/subject/prepare. If you need GRE test preparation materials in an alternate format,

contact ETS Disability Services (refer to page 2).

SCORE REPORTING

Test takers may view their scores in their ETS account (www.ets.org/mygre) approximately 10–15 days after

a computer-delivered test or approximately six weeks after a paper-delivered or alternate format test. Test

takers who are blind may contact ETS Disability Services by phone (refer to page 2) for their test scores.

Testing Accommodations Request Form Part I - Applicant Information

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part I — Applicant Information

Instructions: Complete this page using blue or black ink and sign the Applicant’s Verication Statement on page 15. This

form may also be completed online in your ETS account at www.ets.org/mygre.

Date of application: ______ /______ /______

Month Day Year

Applicant’s Name (print your name as it appears on your ID documents — leave one blank box between names)

First Name M.I. Last Name

Address Line 1

Address Line 2

City State or Province

ZIP or Postal Code Country

Gender

Male Female

Date of Birth

Month

Day

Year

U.S. Social Security Number

(last 4 digits)

Day Phone Number Evening Phone Number

Fax Number Email Address

Test I am applying for: GRE

General Test GRE

Subject Test (Specify:___________________________)

Testing location (for GRE General Test only): I intend to test at home I intend to test at a test center

Nature of your disability (check all that apply):

Blind or legally blind

Low vision

Deaf

Hard-of-hearing

ADD/ADHD

Learning Disability

Traumatic Brain Injury

Autism Spectrum

Disorder

(e.g., Aspergers)

Physical (identify condition)

________________________________________________________________

Psychological (identify condition)

________________________________________________________________

Medical condition (identify condition; must submit documentation)

________________________________________________________________

Other (identify condition; must submit documentation)

________________________________________________________________

When was your disability rst diagnosed? _____ /_____

Month Year

Date of professional’s most recent evaluation: _____/_____

Month Year

Other than testing accommodations, describe what strategies, devices or medications you ordinarily use to manage your

condition (Optional):

_________________________________________________________________________________________________

FORMS

Testing Accommodations Request Form Part I - Applicant Information

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part I — Applicant Information (continued)

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 specically use

our website. This also includes our use of biometric data (including ngerprints, audio recordings, facial images and video

les) 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

afliates 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.

Testing Accommodations Request Form Part I - Applicant Information

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.

If required under applicable laws, at your request and on satisfactory proof of identity (as determined by ETS), we will

provide you (i) conrmation that we hold your Personal Information; (ii) details or a description of the Personal Information

we hold in an intelligible form; (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 request 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 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 conict 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.

ACKNOWLEDGMENT (cont.)

Testing Accommodations Request Form Part I - Applicant Information

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 qualications 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 ve 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.

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 afliates will not be required to take reasonable steps to ensure that ETS or

its afliates’ use of such data outside of Australia does not breach the Australian Privacy Principles.

For Canadian residents only: This is the notication 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 procedure 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.

ACKNOWLEDGMENT (cont.)

Testing Accommodations Request Form Part I - Applicant Information

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part I — Applicant Information (continued)

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

Verication Statement to Be Signed by Applicant

I attest to the fact that the information recorded on this application is true, and if this application is not sufcient, I

agree to provide ETS with any additional information or documentation requested in order to evaluate my request for

accommodations. I also give permission to release to ETS a copy of any pertinent information required to establish the

need for the accommodation(s) requested herein. If I am requesting the use of an assistive device, I am familiar with its

use.

I understand that all information that is necessary to process this application must be available to ETS

sufciently in advance of the test administration date to provide time to evaluate and process my request

for accommodations. I also understand that processing may take approximately four to six weeks from the time the

application is complete. If additional documentation must be submitted, it may be another two to four weeks from the time

the new documentation is received until the review is complete. I acknowledge that ETS reserves the right to make nal

determination as to whether any requested accommodation is warranted and appropriate.

If I am submitting Part III — Certication of Eligibility: Accommodations History form, I acknowledge that my request for

accommodations will not be processed if I alter or revise Part III in any way after the appropriate ofcial has completed it.

I also understand that ETS does not waive its right to ask the person who completes Part III on my behalf to submit the

supporting documentation, if necessary, either before or after the test administration date.

I authorize any person completing Part III — Certication of Eligibility: Accommodations History form on my behalf to

release this information to ETS upon ETS’s request. I also understand that the documentation in support of my request for

accommodations supersedes any information contained in Part III — Certication of Eligibility: Accommodations History

form. For quality assurance, Part III — Certication of Eligibility: Accommodations History form may be subject to audit

resulting in a review of the actual disability documentation on le.

I acknowledge that any submitted information may also be used for research purposes, and that in no case will any

individual be identied by name in research studies, and that the information will be protected by the terms of ETS’s

Condentiality of Data Policy.

I further understand that ETS reserves the right to withhold or cancel my scores if it is subsequently determined that,

in ETS’s judgment, any information presented in this application or supporting documentation is either questionable,

inaccurate, or used to obtain accommodations that are not necessary.

I understand that ETS has contracted with an external panel of expert consultants with whom it may consult to augment

its in-house expertise. By submitting my request for accommodations, I authorize and provide my consent to ETS to share

my personal information as needed concerning this request.

_______________________________________________________ ____________________

Signature of Applicant Date

Keep a copy of this completed form for your records.

Testing Accommodations Request Form Part II - Accommodations Requested

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part II — Accommodations Requested

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

Date of application: ______ /______ /______

Month Day Year

REQUESTED ACCOMMODATIONS (Check all that apply)

Extended Testing Time (NOTE: All tests are timed; if you are requesting more than 50 percent extended test time,

documentation must be submitted.)

□ 25 percent (time and one-quarter) 50 percent (time and one-half) 100 percent (double time)

Extra Breaks. Breaks are not included in testing time (can be used for medication, snacks, trips to the restroom, etc.)

□ Yes

Accommodations for Computer-delivered Tests

□ Screen magnication

□ Selectable background and foreground colors

□ JAWS screen reader (only applicants who are blind, legally blind, or have low vision)

Alternate Test Formats

□ Braille (only applicants who are blind, legally blind, or have low vision)

□ Large-print test book

□ Large-print answer sheet (applies to the GRE Subject Tests only)

□ Recorded audio

□ Recorded audio with tactile gure supplement (only applicants who are blind, legally blind, or have low vision)

□ Recorded audio with large-print gure supplement (only applicants who are blind, legally blind, or have low vision)

Testing Accommodations Request Form Part II - Accommodations Requested

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part II — Accommodations Requested (cont.)

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

Assistance (Note: If you are requesting a human reader and/or a scribe, and your disability is Not blindness or legal

blindness, you must submit documentation for review.)

□ Human reader (Only at test centers)

□ Human scribe (Only at test centers)

□ Sign language interpreter for check-in assistance and spoken directions only (only for applicants who are deaf or hard

of-hearing) (Only at test centers)

□ Oral interpreter for check-in assistance and spoken directions only (only for applicants who are deaf or hard-of-

hearing) (Only at test centers)

□ Braille slate and stylus for note taking only (for applicants who are blind, legally blind, or have low vision)

□ Perkins brailler for note taking only (for applicants who are blind, legally blind, or have low vision)

Other Accommodations. If you are requesting accommodations other than those listed above (e.g., medical

supplies/assistive devices), please describe them below (including make/model information, if applicable) and submit

appropriate documentation.

1. ______________________________________________________________________________________________

2. ______________________________________________________________________________________________

3. ______________________________________________________________________________________________

4. ______________________________________________________________________________________________

5. ______________________________________________________________________________________________

Testing Accommodations Request Form Part III - Certication of Eligibility: Accommodations History

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part III — Certication of Eligibility: Accommodations History

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

All applicants are encouraged to submit Part III — Certication of Eligibility: Accommodations History form which serves

two distinct purposes:

• to provide verication of an individual’s use of accommodations in either college or in the workplace

• as a shortcut for approval of certain specic accommodations for most disabilities.

A completed Part III — Certication of Eligibility: Accommodations History form will only be considered in place of disability

documentation from qualied applicants with a

1. Learning Disability (LD), Attention Decit Hyperactivity Disorder (ADHD), Traumatic Brain Injury (TBI), Autism

Spectrum Disorder (ASD), psychiatric disabilities and/or physical disabilities, who are requesting 50% extended

test time or less and/or additional breaks only; OR

2. Visual impairments or hearing loss, who are requesting those accommodations listed on pages 6 and 7 for these

conditions.

For individuals with medical or chronic health-related conditions, or for any other accommodations (double time, scribe,

reader, etc.) applicants must submit disability documentation directly to ETS for review.

This form must be completed and signed by an authorized professional representing one of the following:

• Ofce of Accessibility/Disability Services at test taker’s college or university

• Human Resources ofce at test taker’s place of employment

• Department of Vocational Rehabilitation (DVR) ofce in test taker’s state of residence

Certication of Eligibility: Accommodations History forms completed and signed by members of the applicant’s

family, or by the individual who diagnosed or is treating the disability, will not be considered.

After reading this page, please complete pages 19 to 22.

Testing Accommodations Request Form Part III - Certication of Eligibility: Accommodations History

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part III — Certication of Eligibility: Accommodations History (cont.)

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

DIRECTIONS FOR COMPLETING THE CERTIFICATION OF ELIGIBILITY:

ACCOMMODATIONS HISTORY

The Certication of Eligibility: Accommodations History form may be used in lieu of documentation or as verication of the

accommodations used in college or in the workplace. The authorized professional should initial each of the documentation

criteria listed below. Please clearly write your initials for each item.

Does the candidate’s documentation…

Yes No N/A

1. Meet the recency criteria set forth at www.ets.org/disabilities (e.g., LD, ADHD,

and/or ASD within 5 years; psychiatric with 1 year, etc.)?

2. Include complete educational, developmental, and medical history relevant to the

disability for which accommodations are being requested?

3. Describe the functional limitations resulting from the diagnosed disability?

4. List the test instruments used in the evaluation report and relevant subtest scores

used to document the stated disability? (All test instruments should have adult

norms.)

5. Describe the specic accommodation(s) requested and adequately support each

requested accommodation?

6. Present itself on ofcial letterhead, printed or typed, signed and dated by an evaluator

qualied to make the diagnosis (include information about license, certication, and

area of specialization)?

Provide the following information regarding the disability documentation on le:

Name and credentials of the professional who completed the most recent evaluation.

(e.g., Susan Smith, MD, Psychiatrist)

___________________________________ ______________ _________________________________

Name Degree Area of Expertise

B. Date of professional’s most recent evaluation: _______ /_______

Month Year

Testing Accommodations Request Form Part III - Certication of Eligibility: Accommodations History

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part III — Certication of Eligibility: Accommodations History (cont.)

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

C. Applicants diagnosed disability or disabilities, as stated in the documentation, for which accommodations have

been granted:

_________________________________________________________________________________________

D. Please indicate the accommodations the applicant has received at your institution.

Extended testing time (Note: All tests are timed; if applicant is requesting more than 50% extended test time

documentation must be submitted).

25% 50% 100% Other _____

Please list all other approved testing accommodations: If the student used a “reduced distraction testing

environment,” please describe that environment.

1. __________________________________________________________________________________

2. __________________________________________________________________________________

3. __________________________________________________________________________________

4. __________________________________________________________________________________

5. __________________________________________________________________________________

E. During what period of time has the applicant used the above accommodations?

From _______ /_______

Month Year

To _______ /_______

Month Year

Testing Accommodations Request Form Part III - Certication of Eligibility: Accommodations History

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part III — Certication of Eligibility: Accommodations History (cont.)

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

F. Has the applicant used these accommodations for at least one semester or four months?

_____Yes _____No

G. Where has the applicant used the accommodations?

□ College/University

□ Place of Employment

□ Other (indicate): ________________________________________

I certify the accommodations indicated in Part III — Certication of Eligibility: Accommodations History form were

documented as necessary and approved for the applicant.

I certify I have reviewed the Educational Testing Service (ETS) Documentation Criteria (including ETS guidelines

about LD, ADHD and psychiatric disabilities, if applicable), and the applicant’s documentation supporting the disability

or disabilities and the need for specic accommodations meets those criteria and is on le in this ofce. For quality

assurance, Part III — Certication of Eligibility: Accommodations History form may be subject to an audit resulting in a

review of the actual disability documentation on le.

In the event ETS requests a copy of any of the documentation cited above, I agree to send ETS, for its consideration, the

complete le of documentation pertinent to establishing the need for these accommodations. I understand the applicant

authorizes the release of this information pursuant to the applicant’s verication statement.

I also understand if ETS determines at any time the applicant’s documentation does not meet ETS’s Documentation

Criteria, ETS will withhold or cancel the applicant’s score(s).

click to sign

signature

click to edit

Testing Accommodations Request Form Part III - Certication of Eligibility: Accommodations History

GRE

TESTING ACCOMMODATIONS REQUEST FORM

Part III — Certication of Eligibility: Accommodations History (cont.)

Applicant’s Name:

(please print)

___________________________________________________________________________

First Name M.I. Last Name

_________________________________________ _____________________________

Authorized Professional’s Verication Statement

To be signed by an authorized person in the Ofce of Accessibility/Disability Services, a Human Resources

counselor at place of employment or a Vocational Rehabilitation counselor. Note: The evaluator who

diagnosed or is treating the individual cannot complete this form.

Signature of Authorized Professional Date

_________________________________________________________________________________________________

Print Name

_________________________________________________________________________________________________

Title

_________________________________________________________________________________________________

Name of Institution/Agency/Place of Employment

_________________________________________ _________________________________________

Telephone Fax #

_________________________________________________________________________________________________

Email Address

Attach Business Card Here

2021–22 GRE Test Authorization Request Form

2021–22 GRE

Test Authorization Request Form for Test Takers

with Disabilities or Health-related Needs

Test takers with disabilities or health-related needs can request accommodations online at

www.ets.org/mygre. Use this form ONLY if you are a test taker with a disability or health-related needs,

are requesting testing accommodations and are submitting your request by email, mail or courier service.

• To request testing accommodations, complete this form and follow the instructions in the

GRE

Bulletin Supplement for Test Takers with Disabilities or Health-related Needs at

www.ets.org/gre/disabilities.

• After your accommodations have been approved, you will be provided with payment options.

Submitting Requests by Mail or Courier Service Submitting Requests via Email

Mail:

ETS Disability Services

P.O. Box 6054

Princeton, NJ 08541-6054

USA

Courier Service:

ETS Disability Services

225 Phillips Boulevard

Ewing, NJ 08628-1426

USA

Email:

disability.reg@ets.org

*Required Field

*Preferred Test Date (For Subject Test dates, visit

www.ets.org/subject/register/centers_dates.)

Test Location: Choose two test locations in order of preference. Print the city and country for each choice below.

See available test centers at www.ets.org/gre/centers.

First-choice Test Center City and Country Second-choice Test Center City and Country:

*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):

2021–22 GRE Test Authorization Request Form

2021–22 GRE

Test Authorization Request Form for Test Takers with Disabilities or Health-related Needs (cont.)

*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):

I understand and acknowledge the terms and conditions outlined in the Acknowledgment attached on

pages 25–27 of this form.

I hereby agree to the conditions set forth in the 2021–22 GRE

Information Bulletin and on the GRE website,

specically those concerning test administration, payment of fees, the reporting of scores and the condentiality

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:

Educational Testing Service (ETS) in the United States and other countries.

Acknowledgment