School Equivalency Records Request

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Arizona High School Equivalency Records Request
Mailing Address:
nstructions
I
Arizona Department of Education
Adult Education Services Bin #26
Please clearly fill out Section 1 and Section 2 of this form, and mail to us with the
1535 W. Jefferson St.
applicable fee. (See below for fees).
Phoenix, AZ 85007
An original signature is required for us to process the request (NO electronic signatures).
Transcripts and Verifications are processed within 2-3 business days.
Walk-in Location:
ADE/Adult Education Services
We only accept Money Orders or Business Checks for requests .
3300 N. Central Ave., Suite 2360
3rd Party Verifiers: Call (602) 258-2410, option #2 for questions on the verification process.
Phoenix, AZ 85012
Hours: M-F 8:00am-5:00pm
My Information
Section 1—
Current Legal Name (REQUIRED) (First, Middle, Last)
Social Security Number (REQUIRED)
-
-
Name During Test—Required if different than above (First, Middle, Last)
Date of Birth (REQUIRED)
/
/
Current Mailing Address
City, State, Zip Code
Current Phone Number
(
)
-
Test Center Name/Approx. Testing Location (optional)
Approx. Test Date
Please Send My Records To...
Section 2—
Check here to send your transcript to the above address.
Name of Business, Educational Institution, etc.
Attention (Specific individual or Dept.):
Mailing Address (No P.O. Box if shipping overnight) City, State, Zip Code
Business Phone Number
(
)
-
Certification: “I hereby certify that all information provided is completely true, and I authorize the release of my
scores to the requestor.” Applicant Signature (Required by Student Privacy Act)
Signature
Date
/
/
Payment: Money Order or Business Check ONLY;
Made Payable To: AZ Department of Education
Check all that apply
Transcript PRIOR to 1985: $15.00
Check here for FedEx Overnight Priority
(includes Microfilm Search & 1 official transcript. For additional transcripts,
Shipping: $20.00
please check Transcript box below and indicate quantity.)
(in addition to transcript fee)
Transcript 1985—Present: $10.00 X Quantity
Restrictions apply; Cannot send to P.O.
Boxes, Street Addresses only.
Verbal Verification (3rd Parties Only) PRIOR to 1985: $15.00
Total Amount Enclosed: $____________
Verbal Verification (3rd Parties Only) 1985—Present: $10.00
WE DO NOT EMAIL OR FAX ANY SCORES OR RECORD INFORMATION
I:\AdultEd\AE_GED Shared\Client Services\FORMS\1 Client Services FORMS & PROCESSES\CS FORMS General

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