REQUEST FOR PENNSYLVANIA GED TRANSCRIPT

(Please Print Clearly)

Name _

(First) (Middle) (Last)

Present Address--------------------------------------------------------

(Street)

(City) (State) (Zip)

Social Security#

Date of Birth Year & Place Tested

Previous Names Tested Under

Signature of Examinee

Date

PLEASE MAIL THE OFFICIAL TRANSCRIPT TO: -

South Hills School of Business & Technology

480 Waupelani Drive

State College, PA 16801

A $3.00 non-refundable service fee must accompany this application. This must be in the form of a cashier’s check, money order or certified check made out to the Commonwealth of Pennsylvania. Personal checks and cash are not acceptable and will be returned. Transcripts will be mailed normally within a week to ten days of receipt by this office. If no record is found, the requestor will be notified. We are not unable to give verification by phone, nor are we able to fax responses.

Please complete all information requested on this form. Remit this form and the proper fee to: Commonwealth Diploma Program

Pennsylvania Department of Education

12th Floor

333 Market Street

Harrisburg, PA 17126-0333