Application For Ged Testing Form
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1
2The University of the State of New York
THE STATE EDUCATION DEPARTMENT
High School Equivalency Program
P.O. Box 7348
Albany, New York 12224-0348
(518) 474-5906
APPLICATION FOR GED TESTING
Important:
If any section of this application is incomplete or cannot be read, the application will be returned.
Processing will be delayed or suspended.
PLEASE PRINT CLEARLY IN INK
Candidate Information
1.
Social Security Number
2. Preparation Program Code
Program Name
3.
Name (Last Name)
First Name
Middle Initial
4. Address (Street/P.O. Box)
Apartment Number
5.
City
State
Zip Code
6.
Telephone Number
7. Date of Birth
8. Age
9. Gender
10. In Which Language Do You
Wish To Be Tested?
(_____)___________________
______/______/_______
MALE FEMALE
Check One
Area Code
Number
Month
Day
Year
English
Spanish
French
11. Have you previously tested for the
YES If “YES” you must record the information requested
New York State High School Equivalency
NO
below from your most recent Ineligible Notice/Unsatisfactory
Diploma?
Score Report. If you do not know the Test Center and/or Date
If “NO” go to item 13.
that you took the test(s), give the approximate location and date.
What name did you use at that examination
_______________________________________________________________
Last Name
First Name
Middle Name
IDENTIFICATION NUMBER
TESTING CENTER
DATE OF THE LAST TEST
FORM(S) OF TESTS TAKEN
(at the last exam)
(at last test)
12. Requesting Test Dates and Locations
From the New York State High School Equivalency Program Testing Schedule, select your preferred choice for
test center and date for taking the GED Tests. Then, print below test center and test date. Mail your application
to the test center where you wish to test. You will hear from them when to appear for testing.
TEST CENTER ___________________________________________ TEST DATE _______________________
13.
Are you applying for Special Modifications
If "YES" and this office has already authorized
of the procedures for administering the GED
NO
YES
special test modifications for you, enclose a copy
tests because of a disabling condition
of the authorization letter with your application.
If "YES" and this office has not already authorized special test arrangements for you,
you must enclose with your application a letter specifying what arrangements or
modifications are necessary, and documentation to support your need for the special
arrangements you are requesting. Please send your application and documentation to
the address at the top of this form.
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