GACE Eligibility Form for Test Takers Whose Primary Language Is Not English (PLNE) Copyright © 2018 by Educational Testing Service All rights reserved ETS is a registered trademark of Educational Test[.]
Eligibility Form for Test Takers Whose Primary Language Is Not English (PLNE) This form is to be completed by you (the test taker) and submitted each time you request to test with these accommodations, even if you have previously been approved for these accommodations Mail this form together with the Certificate of Documentation to ETS – GACE, P.O Box 6054, Princeton, NJ 08541-6054 Do not mail this form separately to ETS Incomplete documentation will not be processed and will be returned to you “I attest that the information about me provided on the Certification of Documentation form is true to the best of my knowledge If the certification document is not sufficient for me to obtain the accommodation sought, I give permission to release to Educational Testing Service (ETS) a copy of any pertinent information required to establish the need for the accommodation described herein I understand the necessary information must be available to ETS sufficiently in advance of the intended test date to provide time to process my request and implement the requested accommodations I further understand that my request for this accommodation will not be processed if I alter or revise the certification document in any way after it has been completed by the appropriate official This information will be protected by the terms in the Confidentiality of Information section of the GACE Registration Bulletin.” I have previously submitted the Certification of Documentation for Test Takers Whose Primary Language Is Not English and have approved documentation on file with ETS No Yes* Date _ Test Taker Printed Name Test Taker Signature _ *Complete the following if you have previously tested with these accommodations Test date for which documentation is on file _ Georgia Certification ID number (GA CERT ID) _ Copyright © 2018 by Educational Testing Service All rights reserved ETS is a registered trademark of Educational Testing Service (ETS) Georgia Assessments for the Certification of Educators, GACE, and the GACE logo are registered trademarks of the Georgia Professional Standards Commission (GaPSC)