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ATTACHMENT R: Application for the New ... - …

The University of the State of New York THE STATE EDUCATION DEPARTMENT High School Equivalency (HSE) Office 89 Washington Avenue, EBA 460, Albany, New York 12234 518-474-5906 ATTACHMENT R: Application for the New York State High School Equivalency Credit for Regents Examination Scores PLEASE PRINT CLEARLY IN BLUE OR BLACK INK Section A. For Applicant Use Only Applicant s Name Last Name First Name Middle Initial Suffix Name at time of Regents Examination(s) Taken (if different from above): Applicant s Mailing Address ( Box) Apartment Number CityStateZipCodeApplicant s Date of Birth Month Day Year Applicant s Telephone Number (_____) _____ Area Code Number Applicant s Email Address Applicant s Last School District and School Attended: Have you previously taken a TASC or GED examination in NYS?

The University of the State of New York THE STATE EDUCATION DEPARTMENT High School Equivalency (HSE) Office 89 Washington Avenue, EBA 460, …

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