Fillable form before mailing.: 202122 GRE Subject Test Registration (ETS)

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2021–22 GRE
®
Subject Test Registration Form
You can register for a GRE
®
Subject 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.
View test centers where the GRE
®
Subject Tests are offered at www.ets.org/gre/subject/forms.
Completing this form and submitting payme
nt will register you for a
GRE
®
Subject Test. Once this form has been
submitted, it cannot be canceled or deleted. NOTE: Be sure to complete pages 1–4 and staple the completed
form before mailing.
Do NOT use this form if you are requesting testing accommodations for disabilities or health-related needs. Visit
www.ets.org/gre/disabilities
.
Mail completed form to: ETS-GRE
Box 382013
Pittsburgh, P
A 1
5251-8013 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):
*TEST DATES — For the most up-to-date list of approved dates and locations, see the test center list at
www.ets.org/gre/subjectforms.
Subject Test Dates (select one): ☐ September 11, 2021 ☐ October 23, 2021 ☐ April 9, 2022
1
2021–22 Registration Form for the GRE
®
Subject Tests – Page 2 of 4
* Required Field
Name:__________________________________
TEST TO BE TAKEN:
☐ C27 Chemistry ☐ M68 Mathematics ☐ P76 Physics ☐ P82 Psychology
*TEST CENTER — Enter the test center’s five-digit code from the test center list at www.ets.org/gre/subjectforms.
Test Center Code Location
First Choice:
Second Choice:
SENDING YOUR SCORES — Please select the scores to be reported below. All scores will be reported unless you indicate
otherwise. Options are defined as follows.
• Most Recent Scores: Send scores for the Subject Test for which you are registering
• All Scores: Send scores for all Subject Tests taken in the last five years, including the test for which you are registering
• Do Not Send Scores (Undergraduate Institution only)
UNDERGRADUATE INSTITUTION – Using the Institution and Department Code lists at www.ets.org/gre/subject/forms, enter the
codes for your current or most recent undergraduate institution. If you want your GRE Subject Test scores sent to the graduate,
business or law school at this institution, you will need to enter the institution code in the “Score Report Recipients” section below.
Institution Code Department Code
Send these scores: ☐ Most recent scores ☐ All scores ☐ Do not send
SCORE REPORT RECIPIENTS – Using the Institution and Department Code lists at www.ets.org/gre/subject/forms, indicate
where you would like your GRE Subject Test score reports sent. For each recipient listed, enter the following letter(s) under the
“Scores to Send” box to indicate which score(s) you want reported:
R = MOST RECENT scores will be sent
A = ALL scores will be sent
All scores will be reported unless you indicate otherwise.
Institution
Code
Department
Code
Scores to
Send
Institution or Fellowship Sponsor Location
(City or Country)
Department
GRE
®
SEARCH SERVICE – Think you found the perfect school? Think again. There are thousands of universities and programs that you could
choose from, but you can’t research them all. A university you never dreamed of might be your perfect match, and you’d never even know. Let them
find you! I want to connect with graduate, business, and law schools, fellowship sponsors, and other organizations who participate in the GRE
Search Service. I consent to ETS sharing with Search Service participants my email address and other profile information, so they can
communicate with me about admissions, scholarships, fellowships, and other educational opportunities. The personal information shared may
include gender, ethnic background, citizenship, native language, educational background and objectives, and undergraduate GPA. Broad GRE
score bands (e.g. score ranges) in combination with undergraduate grade point average may be part of search criteria but will not be released to
any participating school. I understand that I will be able to unsubscribe at any time.
☐ Yes, I would like to regist
er for the GRE Search Service and agree to the above.
☐ No, I would not like to r
egister for this Service.
2
________________
2021–22 Registration Form for the GRE
®
Subject Tests – Page 3 of 4 Name:__________________________________
* Required Field
BACKGROUND INFORMATION – Please respond to ALL questions. Completed information will be used to determine suitability for inclusion in
analysis samples, score interpretation data, group statistics and research studies. Individual responses are not communicated to any institution or
agency if you do not participate in the GRE
®
Search Service. An asterisk (*) indicates the field is required.
*a. Of what country are you a citizen? Find the four-digit country code from the list at www.ets.org/gre/countrycode and enter it below.
b. If you are a United States citizen, which state or U.S. Territory do you consider your permanent residence? Find the two-digit code number from
the State and
Territories Code list at
www.ets.org/gre/bulletinandforms
and enter it here.
____________
c. If you are a United States citizen, how do you describe yourself? (Select one.)
1.
☐ American Indian or Alaskan Native
2. Asian or Asian American
3. Black or African American
4. ☐ Mexican, Mexican American or Chicano ☐
☐ ☐ 5. Native Hawaiian or Other Pacific Islander
6. Puerto Rican
7. Other Hispanic, Latino or Latin Amer
ican
8.
☐ White (non-Hispanic)
☐ ☐ 9. ☐ Other
*d. Educational status at the time you tak
e the GRE test (Select one).
2.
☐ Sophomore (second year)
3. Junior (third year)
4. Senior (fourth or final year)
5. ☐ First-Year Graduate Student
6. Second-Year Graduate Student
7. Unenrolled (
College Graduate)
8.
☐ Unenrolled (Master’s Degree)
☐ ☐ 1. ☐ Other
☐ ☐
*e. Do you communicate better (or as well) in Eng
lish than in any other language?
☐ Yes ☐ No
f. What is your native language? Find your nati
ve language from the Native Language Code list at www.ets.org/gre/bulletinandforms and enter
the three-digit code number here.
___________________
g. What is (are) your reason(s) for taking the GRE tes
ts? (Check all that apply.)
1.
☐ Admission to graduate or business school (e.g., M.A., M.B.A., Ph.D.)
2. Fellowship/scholarship application requirement
3. Undergraduate program exit requirement
5. ☐ Practice
☐ 7. ☐ Other
☐
h. Indicate the highest level of educ
ation completed by your parents or guardians. (Select only one check box in each column.)
☐ ☐
Father or Parent/Guardian
Mother or Parent/Guardian
1. Grade school, primary school or less
☐ ☐
2. Some high school or secondary sc
hool
☐ ☐
3. High school or secondary school diplom
a or equivalent
☐ ☐
4. Vocational or technical school
☐ ☐
5. Some college/university
☐ ☐
6. Associate Degree
☐ ☐
7. Bachelor’s Degree
☐ ☐
8. Some graduate or professional school
☐ ☐
9. Graduate (e.g., M.A., M.B.A., Ph.D.) or professional degree (e.g., J.D., M.D.)
i. If you are a United States citizen, were you eligible for a Pell Grant as an undergraduate?
☐ 1. Yes ☐ 2. No ☐ 3. I don’t
know
j. Referring to the Department and Major Field Code list at www.ets.org/gre/bulletinandforms, indicate your undergraduate major field of study by
entering the four-digit code number
here.
____________________
k. What is/was your grade point average in your undergraduate major field of study? (If your college/university does not use letter grades,
please mark the letter grade that is the closest equivalent to your grade average.)
7.
☐ A
6.
☐ A- 5. ☐ B+
4.
☐ B 3. ☐ B- 2. ☐ C+
1.
☐ C or lower
l. What is/was your overall undergraduate grade point average?
7. ☐ A 6. ☐ A- 5. ☐ B+
4.
☐ B 3. ☐ B- 2. ☐ C+
1.
☐ C or lower
m. In what
calendar year did
you
receive or do you expect to receive your bachelor’s
degree? ________________________
*n.
Referring to the Department and Major Field Code list at www.ets.org/gre/bulletinandforms,
indicate the field in which you plan to do your
graduate work by entering the four-digit code. If you are undecided, use 0000. _____________________
3
2021–22 Registration Form for the GRE
®
Subject Tests – Page 4 of 4 Name:__________________________________
o. Please indicate any currently documented visual
, physical, hearing or learning disabilities you have. (Select only one.)
1. ☐ None
☐ 2.
B
lind/visually impaired
3.
☐ Deaf/hard of hearing
4.
☐ Physical disability
5. ☐ Learning disability
6.
☐ Multiple
disabilities
7.
☐ Other
p.
I
n what type of graduate or business school program do you plan to enroll (or are you enrolled)?
1.
☐ Full time
2.
☐ Part time
3.
☐
Undecided
q.
What
is your eventual graduate education object
ive
?
1.
☐ Nondegree graduate study
2.
☐ Master’s (e.g.,
M.A., M.S., M.Ed)
8. S
pecialized master’s in business
7. ☐ M.B.A.
3.
☐ Intermediate (e.g., Graduate
Certificate, Specialist)
9
. J.D.
4.
☐ Doctorate
(e.g., Ph.D.,
Ed.D.) 5.
☐ Not
currently planning graduate study
☐
☐
6.
☐ Postdoctoral study
r. In what geographic region(s) would you prefer to attend graduat
e school? (Select all that apply.
)
I
n the United States
1. ☐ Northeast (CT,
ME,
MA,
NH, RI, VT)
2. ☐ Mid-Atlantic
(DC, DE,
MD,
NJ, NY, PA)
3.
☐ South (AL, FL,
GA, KY,
LA, MS, NC,
SC
,
TN, VA,
WV
)
4.
☐ Midwest (IL, IN, IA, KS,
MI,
M
N, MO,
NE,
ND,
OH, SD,
W
I)
5. ☐ Southwest (AZ,
AR,
NM,
OK, TX)
6.
☐ West (AK,
CA, CO,
HI,
ID,
MT,
NV,
OR, UT,
W
A,
WY
)
O
utsi
de the United States
8
. ☐ Africa
9. ☐ Asia
10.
☐ Australia, New
Zealand and P
acific
Isl
ands
7. ☐ Canada
11.
☐ Eastern Europe and Russia
12. ☐ Mexico, Central Am
erica,
South America and the Cari
bbean
13.
☐ Middle East
14.
☐ Western Europe
s. Ind
icate your intend
ed date of enrollment in gradua
te school. (Select only one.)
J
an. – May
☐ 2022
☐ 2023
☐ 2024
J
une – Aug.
☐ 2021
☐ 2022
☐ 2023
☐ 2024
S
ept. – Dec.
☐ 2021
☐ 2022
☐ 2023
☐ 2024
t
. Indicate how many years of post-grad
uate full-time work experience you have. ___________________
u. How
would you like to pursue your graduate/business degree
?
1.
☐ On campus
2.
☐ Online
3.
☐ A combination of
both
4.
☐ Undecided
T
EST FEES AND ORDER INFO
RMATION
DIRECTIONS:
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in the dollar am
ounts
for all items that apply.
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ode
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Include country and
related test fee where test will be taken.
Fees and terms relating to fees and payment are available at
www.ets.org/gre/fees
.
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______________________________________________
....................................................................... Test Fee: . ______ US$
Standby Registration
.................................................... ______ US$
SUBTOTAL
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subtract from subtotal, if applicable) ................................ US$______
TOTAL AMOUNT ENCLOSED....................................... US$______
If you send a check to us, you aut
horize 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 5-6 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 i
n the United States and other countries
4
__
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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.
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 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 reques
t 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.
5
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.
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.
6
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