National Board for Professional Teaching Standards ®

Assessment Center Appointment Application
for NBPTS WLOE First-Time Candidates

  Name: Note: * denotes a mandatory field
*Candidate ID number:
*First Name (as it appears on a current, valid photo ID):
*Last Name (as it appears on a current, valid photo ID):
  Home Address: Note: * denotes a mandatory field
Address*
City*
State*
ZIP code* (plus 4 if known)  
  Contact Information: Note: * denotes a mandatory field
Work phone*
Home phone
Alternate/cell phone
Fax phone
E-mail address*
  Test Information: Note: * denotes a mandatory field
Are you a retake candidate?  Yes
No
Test Center Information:

Please refer to the test center list for the latest test center information. Not all centers are open on all testing dates. Not all centers appear on the list.

Test center locations are listed in the drop down menu below. Please select your first and second test center choice. If you do not find a test center in your area, fill in ONLY the city and state closest to the location you would like to test. Do not choose a test center from the drop down boxes. You will be assigned to the nearest available center to that location.

There are no available centers within a 125-mile radius of my home. Please schedule me as close as possible to:

City:
State:

These centers are within a 125-mile radius of my home:
Test Center (First Choice) Test Center (Second Choice)

Test Date (First Choice)
(you must select a test date within your test window as shown in the CALENDAR FOR WLOE CANDIDATES ASSESSMENT CENTER EXERCISES.)
May 10, 2008  
Test Date (Second Choice)
(you must select a test date within your test window as shown in the CALENDAR FOR WLOE CANDIDATES ASSESSMENT CENTER EXERCISES)
May 10, 2008  

While every effort will be made to honor your first or second choice of date and test center, this may not be possible due to varying schedules and capacities of individual test centers.


Please click submit only once.