Form Kyae-6 - Ged Testing Application
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2Kentucky Adult Education
1024 Capital Center, Suite 250
GED TESTING APPLICATION
Frankfort, KY 40601
502/573-5114
(PLEASE TYPE OR PRINT)
Website: http:/adulted.state.ky.us/GED.htm
Note:
Applicants with a documented disability may qualify for special testing accommodations. Please contact your
local testing center or the adult education provider for information.
Name (Last, First, Middle Initial or Maiden Name)
Date of Birth (Month/Day/Year)
Age at application
Social Security Number
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Address (Street/Number/Apartment)
State*
City
Zip Code
Home Phone
Work Phone
/-
/-
* *Only examinees with a Kentucky address will be issued a Kentucky diploma.
Name of last school attended
NCES Code
Address of last school attended
City
State
Zip Code
HIGH SCHOOL WITHDRAWAL
If applicant is less than 19 years of age, documented proof of withdrawal from public or private school must be
attached to this application.
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Date of withdrawal from school:
Certify the following by initialing beside each statement:
_______ I certify I have not received a high school credential from any jurisdiction.
_______ I certify I have not previously earned GED scores sufficient to qualify for a high school credential in any jurisdiction.
_______ I certify I have read and understand the testing misconduct policy.
_______ I certify I have not already taken the GED tests more than twice during this calendar year.
_______ I authorize release of my test results to the certifying providers.
_______ I certify all information on this application is accurate.
Signature of Applicant
Date
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X
This signed application must be taken to the test center for admission to testing and is good for 6 months from this date.
Government issued photo identification with name, date of birth, address and signature must be taken to the test center for
admission to testing.
You may need additional signatures on the back of this application to meet eligibility requirements as
outlined in 785 KAR 1:130 and described on the next page of this application.
KYAE-6 Form (rev. 6/05)
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