Page 1:
Carefully fill in your childs name, social security number, gender, date of birth, and ethnicity
(optional). ACTs registration system will not accept names with punctuation (ex., or -). Please
use a space instead.
If you qualify for Free/Reduced Lunch, fill in the Free/Reduced Lunch bubble.
Both you and your child should sign the agreement to participate.
Indicate at the bottom of page 1 whether you would like a copy of your childs scores sent directly to
his/her school. If you indicate Yes, please fill in the complete name and address of the school.
Page 2:
Fill in your address and phone number. If your mailing address is a PO box, please use that.
Fill in your email address. Please use your email address and not the student's. This address is used to confirm your student's registration and contact you about programming opportunities.
Under Students Current Grade Level fill in the oval corresponding to your childs current grade.
Page 3:
Register for a test date and center. EXPLORE test centers are located on the green sheet. ACT Assessment
test centers are located on the pink sheet.
If your child has a condition that requires a special testing accommodation fill in the appropriate bubble.
Page 4:
Indicate the name of the qualifying test and your childs test scores at the top of the page. RETURNING
BESTS students are NOT required to complete this section. Students qualify for BESTS by having one or
more subtest scores at or above the 95th percentile on a standardized achievement test. Please enter ALL
of your childs subtest percentiles on the test, not just the scores that make him or her eligible for
BESTS. Fill in the corresponding ovals. If a subtest was not part of the test, fill in the N.A. (Not
Applicable) oval.
If your child took a test other than the Iowa Tests of Basic Skills (ITBS), please enclose a photocopy
of your childs scores with your completed registration form.
If your child did take the ITBS, you may also enclose a copy of the scores OR if you are a resident of
Iowa you may give your permission to contact the Iowa Testing Program to verify your childs scores.
Test scores must still be filled in.
For Future BESTS: Students qualify for Future BESTS by having one or more subtest scores at or above the
95th percentile on a standardized achievement test -OR- by nomination from a teacher. If your child was
nominated by a teacher, please include a brief nomination letter from the teacher.
Indicate the enclosed fee DO NOT ADD the fees Only fill in ONE bubble.
Indicate your method of payment. If paying by check or money order, please enclose it with your completed
registration form. If paying by credit card, please indicate what type of card (Visa or Mastercard), the
expiration date, and card number. Print your name exactly as it appears on the card, then sign your name
in the space provided.
Return your completed registration form and method of payment by November 15, 2006, in the postage-paid
envelope provided. After November 15, 2006, include the required $15 late fee.
DO NOT FAX THE REGISTRATION FORM.