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ETS, the ETS logo, and PPAT are registered trademarks of Educational Testing Service (ETS) in the United States and other countries.
PPAT® Assessment Fee Reduction Request Form 2020–2021
A limited number of test fee reductions are available for undergraduate or graduate students who meet all eligibility criteria.
See the ETS® Performance Assessments informational website for eligibility and application information.
If you are approved for a fee reduction, the test fee for the PPAT® assessment may be reduced by $100. The reduction will be
provided in the form of a voucher to be used at registration. Registration payments made with prepaid vouchers are not
eligible for this fee reduction. The $100 fee reduction voucher cannot be combined with another voucher when purchasing
Submission window you are applying for: Fall 2020 Spring 2021
Please print all information below.
Date: _________________________________________ ETS Online Account ID: _______________________________
Month Day Year
Applicant’s Name (print your name as it appears in your online account)
First Name: __________________________ M.I.: ________ Last Name: ______________________________________
Street Address: _______________________________________________________________________________________
City: ___________________________________________ State or Province: ___________________________________
Zip or Postal Code: _______________________________ Email Address: ______________________________________
Daytime Phone Number: __________________________ Evening Phone Number: ______________________________
Fee Waiver Request Personal Information (Information provided on this form is considered confidential)
1. Current Education Level (Select one of the following)
Undergraduate Earned Bachelor’s Degree Earned Master’s Degree Earned Doctoral Degree
You are ineligible if you have a Master’s degree or a Doctoral Degree.
2. Name of Institution or Agency Requiring Your Scores
(must be an authorized score recipient) ________________________________________________________________
3. Name of Institution You Currently Attend _______________________________________________________________
This completed form, Enrollment Verification Certificate, and FAFSA Student Aid Report (SAR) must be received by the
deadline. Late or incomplete requests will not be processed. Note that fee reduction funds are limited. Funds may be
exhausted prior to the deadline.
Submission Window Deadline for Request
Fall 2020 August 26, 2020
Spring 2021 January 15, 2021
Send completed form and required paperwork:
Fax: (609) 683-2040