LASACT CEB Test Payment Form

Test Payment Form

P.O. Box 80235 Baton Rouge, Louisiana 70898-0235 | www.LASACT.org
Applicant information will be entered into the testing system once YOU submit a copy of ADRA’s approval to test email, a completed Test Payment Form, and the required fee. Information regarding selecting a testing date (a minimum of five days out) and location site will be generated by the testing company. (Be sure to check spam/junk mail folders.) An admission letter will be emailed to the applicant and must be brought to the test site along with a photo ID. NO ADMISSION WITHOUT THESE ITEMS.

Failure to submit ADRA approval to test, emailed to CEB@lasact.org, will ultimately result in the delay of this application and scheduling of this exam.
Applicant Information
LAST Name
First Name/M.I.
Name

Last NameMiddle NameFirst Name/M.I.
Email Address
example@example.com
Work Phone Number
Please enter a valid phone numberFormat: (000) 000-0000.
Cell Phone Number (if applicable)
Please enter a valid phone numberFormat: (000) 000-0000.
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Today's Date

MonthDayYear
Select today's date
Testing Options

Please select only one option in each section.
ADRA/CEB Test Offerings:
Are you seeking to take a non-ADRA exam?
Payment Options:
Testing History:

Second or more time testing for above exam. Number of attempts at exam:
Remote Testing (If applicable, please select Remote Testing payment option below):
Special Accommodations:
Payment Information

Please select only one testing option below.
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Acknowledgments
I acknowledge that remediation is required after FOUR (4) failed testing attempts.
Failure to submit ADRA approval to test, emailed to CEB@lasact.org, will ultimately result in the delay of this application and scheduling of this exam.
Please retype the following sentence in the field below: I will submit my ADRA approval letter to test to CEB@LASACT.org
NOTE: A 90-day waiting period will be enforced for those applicants wishing to retest for any of the above-listed exams. Information regarding Test Preparation classes and study material can be found on the LASACT website: www.lasact.org.
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Test Payment Form

Applicant Information

Testing Options

Payment Information

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Acknowledgments