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Subject

Request Form

Your Email Address

***

Subject

Description

Your Name (First & Last)

Your Phone # (XXX-XXX-XXXX)

Please note: This is a secure transaction. Data is encrypted.

Test Taker Age

Court ordered, Job Corps, Probation Officer, TJJD, DFPS?

Test Taker Information:

Test Taker Name (First & Last)

Test Taker Date of Birth (MM/DD/YYYY)

Test Taker Email

***

Please provide the test taker's account number(s) for the test provider(s) selected.

GED ID (########-####-####) www.ged.com

The above test taker is eligible to take the High School Equivalency Exams based on the following exception: (Texas Education Code (TEC) Sec 7.111 (a-1)(2)) (Parts A, B, C & 3)

Institution/Court Information:

Name of Institution or Court referenced above

Name of Representative from Institution or Court (if different from above)

Representative Phone Number (if different from above)

Representative Email (if different from above)

If this ticket is not submitted by a representative of the Institution or Court, please attach the court order below.

I attest to the fact that I am the custodial parent/guardian of the minor identified in the test taker name field.

My son/daughter is not enrolled in school and has my permission to take the high school equivalency exam noted above.

TEA will verify non-enrollment. If it cannot be verified, we will contact you for further documentation.

If passing scores are achieved on the exams, I understand that a State of Texas Certificate of High School Equivalency will be issued.

I agree that TEA may provide my son/daughter's results and certificate status to the local education provider or college (if applicable).

Attachment