California High School Proficiency Examination

Registration Information Correction Form

Information on Ticket:
All fields are required

CHSPE ID

Last Name

First Name

Mid. Int.

Date of Birth:

(mm/dd/yyyy)

New Information:
Only enter items which need correction.

Last Name

First Name

Mid. Int.

Daytime Phone		Fax
E-mail:

Mailing Address (Street Address or PO Box)
City	State	ZIP Code

School (if currently enrolled)

District (if currently enrolled)

Student ID Number (if enrolled in a public school)

I certify that the information provided on this form is accurate to the best of my knowledge and that I am the person whose name appear on this form. I have read and am familiar with the processes governing the CHSPE as they appear in the Information Bulletin. I understand that imcomplete, inaccurate, or missing information on this form may delay or jeopardize my registration or results.


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