Family & Community Adult Education
General Educational Development (GED)

Form for Requesting Simple Verification of GED

(Fax number as of 10/21/05 - 781-338-3089 - Attn: GED Office )

To be filled out by the agency/company requesting verification:

Individual's Name:

Social Security Number:

Date of Birth:

Date GED Received:

Please attach Release Form or have individual sign here: ____________________________

(ALL INFORMATION MUST BE PROVIDED IF REQUEST IS TO BE PROCESSED.)

Company /Agency Requesting Verification:

Contact Person:

Address:

Fax :

Phone:

(RESPONSE WILL BE RETURNED WITHIN 2 - 3 WORKING DAYS FROM DATE REQUEST IS RECEIVED AT GED OFFICE)

FOR GED OFFICE USE ONLY:

Information Missing:

No record of GED:

Comments:

Effective /rev. 9/26/02