ATTACHMENT - B
 
The University of the State of New York

THE STATE EDUCATION DEPARTMENT

GED Testing Office

P.O. Box 7348

Albany, New York   12224-0348

(518) 474-5906

 

VERIFICATION FORM FOR

NEW YORK STATE GED TEST APPLICANTS 17 OR 18 YEARS OF AGE

NOTE: This form is to be used by GED test applicants aged 17 or 18 who have not attended a regular full-time high school program for one year or more, or whose high school class has already graduated or who have been home schooled.  It must be completed by an official of the school district last attended by the applicant.

 

PLEASE PRINT CLEARLY IN INK

To be Completed by

Applicant

v      Fill in your name, Social Security number, age and date of birth.

v      Have an official at the school you last attended complete the section below.

v     Attach this original Verification Form to your completed and signed "Application for GED Testing."

Last Name

 

 

First Name

Middle Initial

Social Security Number                                                                 Age

Date of Birth

 

 

         Month             Day                    Year

 

To be Completed by School Official

 

 

v     Fill in your school's information below.

v     Check and complete the statement that applies to the above candidate.

v     Sign, date and provide your title.

v     Affix school's official seal or stamp in the space provided.

School Name

 

Phone Number

    (         )

Address

 

City

 

 

 

State

Zip Code

r By signing below, I am verifying that *__________________ was the last day of attendance, dismissal or discharge of the above-named individual and that he or she has not been a regularly enrolled student since that time.  *This date cannot be prior to June 30th of the school year in which the candidate reached "maximum compulsory school attendance age" (turned 16 or such older maximum age as the board of education of the school district designates for required school attendance pursuant to Section 3205(3) of Education Law).

                                                                                  OR

r By signing below, I am verifying that the above-named individual did not complete requirements for graduation with the class of _______________ (based on his or her ninth-grade enrollment) that will graduate or graduated on
___ ___    ___ ___    ___ ___ ___ ___  .                 OR

r By signing below, I am verifying that the above-named individual has been home schooled and has reached “maximum compulsory school attendance age." (The school year in which he or she turned 16 or such older maximum age as the board of education of the school district designates) has ended (June 30).

Name of School Official (PLEASE PRINT)

 

 

 

 

 

 

 

 

Title of School Official

 

 

              Signature of School Official                                                     Date