Louisiana HiSET Testing Scholarship Application

Louisiana HiSET Testing Scholarship Application

This form must be completed and submitted online. You can start an application and save your progress for later. Any questions or issues, please contact adulteducation@lctcs.edu.
Section 1 – To be completed by applicant
Applicant Name (exactly as it appears on State/Government issued ID)

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
ETS (Testing) ID Number
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parish
Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
STUDENT STATEMENT: Please type a brief essay regarding what receiving this scholarship and earning your high school equivalency diploma would mean for you.
ACKNOWLEDGEMENTS: Please read each statement and check the required box
Signature of Applicant
Date (Applicant Signature)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Section 2 – To be completed by Louisiana Adult Education Supervisor
Name of the Louisiana Adult Education Program currently attending
Program Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Student's Louisiana Adult Education Enrollment

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Number of Instructional Attendance Hours

Pre-Test and Post-Test Information

Official Practice Test (OPT) Form Used
Date OPT Completed
OPT Scores indicate Prepared or Well-Prepared in the following subjects
Type of HiSET Test Needed
I certify that the applicant is currently enrolled in our Louisiana Adult Education program, has demonstrated a financial need, and the information reported above is accurate and can be verified in the Louisiana Adult Education Student Information System.
Name of Adult Education Staff assisting student with this application:

First NameLast Name
Enter the email address of your Adult Education Director or Supervisor so the submitted application can be routed to them for an electronic signature.
Adult Education Director/Supervisor Email Address:
example@example.com
Should be Empty: