|
GED Official Request Form
Georgia Department of Technical and Adult Education Office of Adult Literacy/GED Testing Services 1800 Century Place, Suite 555 Atlanta, Georgia 30345-4304 (404) 679-1644 Hours of operation for Walk-Ins: 12 Noon - 4:00 p.m., Tuesday – Friday. Faxed requests are not accepted. Requests without appropriate payment and or signature will not be processed. Allow three weeks for processing. Payment: Money Order or Cashiers Check (NO PERSONAL CHECKS ACCEPTED) Fees: Please Print. Complete all items below to assist in completing your request. Name: ________________________________________________________________________ Legal Name at time of testing: _____________________________________________________ Current Address: ________________________________________________________________ City: _________________________________ State: ___________ Zip Code: _____________ Social Security Number: ____________________ Date of Birth: ______________ Where were you tested? __________________________________ What year? ___________
Did you pass?
Are you requesting:  Transcript (Official copy of GED Scores) How many? ___________ Replacement GED Diploma Miniature GED Diploma
Complete mailing address where documents are to be forwarded:
____________________________________________________________________________________________ Signature: ________________________________________ Date: __________________ OFFICE USE ONLY
Cash Money Order Cashier’s Check
Amount Received $__________ Received by: _______________________________________ |