Form Kyae-6 - Ged Testing Application Page 2
ADVERTISEMENT
1
2COMPLETE ONLY IF YOU MEET ONE OF THESE CONDITIONS
You will need an additional signature if you meet one of the following conditions outlined in 785 KAR 1:130:
1. If you are in a juvenile detention center or juvenile holding center, you must have the signature of the local school superintendent.
2. If you are a state agency child, you must have the signature of the child program administrator.
3. If you are in the Secondary GED Program, you must have the signature of the local school superintendent.
4. If you have requested and been granted a waiver of the 90-day school withdrawal provision for one of the reasons below, you must
have the superintendent (or designee) signature.
The superintendent (or designee) granting a waiver of the 90-day withdrawal provision (block 4), please check one of the following:
___Employment Condition
___ Postsecondary Enrollment
___Medical Reason
___Family Circumstance
____Other
Name of Local School District
City
County
or State Agency
Print Name
Date
Phone Number
//
/-
Authorized Signature
X
TEST READINESS CERTIFICATION
Applicants are required to be certified as test-ready by a local adult education provider. THIS FORM MUST BE
COMPLETED BY AN APPROVED ADULT EDUCATION PROFESSIONAL.
This certifies the applicant has passed the Official GED Practice Test and is eligible to take the GED Test.
Signature of Adult Education Provider
Program Name
X
Provider Phone Number
Provider Code
Print Name
/-
Number of hours spent preparing for GED
Provider E-mail
Test________
Applicant Name (Last, First, Middle Initial or Maiden Name)
Date of Birth (Month/Day/Year)
Age at application
Social Security Number
//
--
Official Practice Test Scores
Language
Social
Language
Date
Science
Math
Total Points
Average
Arts, Writing
Studies
Arts, Reading
KYAE-6 Form (rev. 6/05)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal