California High School Proficiency Examination

Online Registration Form

This registration requires the use of Adobe Acrobat.

This Registration Form requires JavaScript to be enabled in your browser. It appears you have this disabled. This form will NOT function correctly. Please enable JavaScript and refresh your browser.

Important: When you complete this form and hit the "Submit Registration Form" button, the information you entered will be electronically transmitted to the CHSPE Office but you will not yet be registered. To complete your registration, print the PDF Registration Form that appears, hand correct any incorrect information, sign the form, and if necessary, have a school official complete the "School Eligibility Verification" section. Then, mail the completed and signed Registration Form with proper payment and any required documents.

Your Registration Form will not be processed and you will not be registered unless the CHSPE Office receives all required registration materials by the appropriate deadline.

* = Required Field

Legal Name:*
You must use your legal name. The name you use to register must match both (a) the name on your proof of eligibility and (b) the name on your photo identificiation required for admission to the test site.

First Name
Mid Init
Last Name

Date of Birth:*

Month

Day

Year

Gender:* Male Female
Daytime Telephone: () -
Fax (if available): () -
E-Mail Address:
Your e-mail address will only be used for official CHSPE correspondence. You must provide an e-mail address and password if you want the ability to print an Admission Ticket or view your unofficial test results at the CHSPE Web site. A confirmation of registration will be sent to this email address.

Creating a password will allow you to reprint your Admission Ticket online and gain access to online results before paper results are mailed. If you create a password, you must provide an e-mail address, as that will be used as your username. If you are re-registering, you must select a new password for each test date. If you are registering multiple people under one email address, you must choose a different password for each.

Password:
4 to 8 characters (letters and numbers only)

I choose not to provide an email and password

Mailing Address:*

PO Box or Street Address

City
State
ZIP Code

School Enrollment:*

In what grade are you currently enrolled, if any?

If enrolled in Grade 12 or below, complete the following:

School Type
Public Private Charter

School CDS Code
Search for CDS Code

School County

School District

School Name

Student ID Number (if in public school)

Eligibility:*

New Registrant

You must use one of these methods to establish your eligibility to take the CHSPE. If you will be 16 years of age or older on the test date, you can choose either Method A or Method B. If you will be under 16 years of age on the test date, you must use Method B.

Indicate which method you are using:

Method A: Enclose one of the specified documents that shows your birthdate. View Valid Documents List

Method B: Have the appropriate school official complete and sign the "School Eligibility Verification" section of your printed Registration Form. This section must include a school's official seal. (provided after submitting this form).

If you are using Method B and your school does not have a CDS code, you must enclose a copy of your school’s Private School Affidavit (R-4) or statement in lieu of Affidavit when you mail your registration materials. Check this box to acknowledge that you must enclose an R-4 or statement in lieu.

Reregistering

	If you have taken the CHSPE since January 2003, you do not need to provide proof of eligibility. Please provide your CHSPE ID # (if known).
	CHSPE ID:

Test Date:*
March 20, 2010

Sunday Testing:

Are you applying for Sunday Testing? Sunday testing is offered on the day following the exam to examinees who cannot test on Saturdays due to religious reasons. Sunday Testing is limited to certain testing areas. If you indicate that you are registering for Sunday Testing, only the test areas available for Sunday testing will show up when you are prompted to choose a test area.

		I am requesting Sunday testing for religious reasons.:
			I will attach a letter from a member of my clergy.
			I am re-registering and my letter is on file from previously testing on Sunday since January 2003.

Test Area:*
Select a city within a given county (indented items), not the county itself.

These lists will change depending on test date selected.
If first-choice has already been filled, you will be assigned to your second choice.

First Choice
Second Choice

Assignment to your first-choice area will be based on availablility upon receipt of your registration materials.

Test areas are identified by cities. A specific test site for an area will be in the general vicinity of the listed city, but may not be within the actual city limits.

If my first choice is not available, return my registration materials unprocessed.

Physical Needs:

Do you have needs regarding physical access?

	No, I have no such needs.
	Yes, I have physical needs regarding access or monitoring blood sugar and will attach a letter.

Testing Accomodations:
Are you requesting Accommodations? If yes, you must attach the Accommodations Request Form and required documentation.
No Yes

Background Information:
Items 16 through 19 are optional. Any information that you provide will be kept confidential. It will not be used in any way to make a determination about any individual.

Ethnic Background: (Optional)

In Part 1, indicate whether or not you are Hispanic or Latino. In Part 2, regardless of how you responded to Part 1, mark one or more boxes to indicate what you consider your race to be.

Part 1: Are you Hispanic or Latino?

	Yes
	No

Part 2: Mark one or more.

	American Indian or Alaskan Native
	Asian Indian
	Black or African American
	Cambodian
	Chinese
	Filipino
	Guamanian
	Hawaiian
	Hmong
	Japanese
	Korean
	Laotian
	Other Asian
	Other Pacific Islander
	Samoan
	Tahitian
	Vietnamese
	White

First Language: (Optional)
Which language(s) did you first learn as a child?

Parent/Guardian Education Level: (Optional)

Which describes the education level of your most educated parent/guardian?

Home Language (Optional)
What is the language most often spoken by the adults at home?
Fees and Payment:
Please indicate the fee that applies to you:

Certification of Accuracy:*

By checking the box to the left, 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 appears 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 incomplete, inaccurate, or missing information on this form may delay or jeopardize my registration.

DO NOT print this page.
A printable PDF Registration Form will be created for you.

Print the PDF Registration Form that appears after you hit the "Submit Registration Form" button. Then:
- hand-correct any incorrect information,
- sign the form, and
- If using Method B (see eligibility), have a school official complete the "School Eligibility Verification" section and place an official school seal (may require a Private School Affidavit).
Obtain proof of eligibility (if using method A; see eligibility)
Complete and/or obtain any documentation for special arrangement requests (i.e. physical access, Sunday testing, testing with accommodations).
Purchase a money order or bank-issued cashier's check in the appropriate amount payable to California Department of Education.
Mail all of the above items to the CHSPE Office for processing

Your Registration Form will not be processed and you will not be registered unless the CHSPE Office recieves all required registration materials by the appropriate deadline.


About CHSPE \| Registration \| On Test Day \| Results & Transcripts \| Contact \| Test Centers \| District Login

	Content produced by the Sacramento County Office of Education for the CA Department of Education. Site Designed and Maintained by Educational Data Systems. (new)