GED OFFICE SCHOOL WITHDRAWAL FORM

DIVISION OF WORKFORCE DEVELOPMENT

AND ADULT LEARNING

Maryland GED® Office

1100 N. Eutaw Street, Room 121

Baltimore, MD 21201

PHONE: 410-767-0538 • EMAIL: ged.dll[email protected]v • INTERNET: www.dllr.maryland.gov

GED OFFICE SCHOOL WITHDRAWAL FORM

To register to take the GED® tests if you are 17 or 18: You must provide verification of official withdrawal from school by submitting

either the completed School Withdrawal section or the completed Home-School Verification section.

**The ORIGINAL must be returned to the Freestate ChalleNGe Academy.

SCHOOL WITHDRAWAL VERIFICATION FORM

If you are enrolled in high school, you must officially withdraw before registering for the GED® tests. This form is to be completed by

an official at the last regular full-time public or private school you attended. The form must have the school stamp or embossed

official school seal. DATE____/_____/_____

month day year

Our records indicate that: Full Name ___________________________________________,whose

student ID # is ________________________ and whose birth date is _____/_____/______

month day year

withdrew from this school on _____/_____/_______ after completing grade ___________.

There is no indication of transfer of records to any other secondary school.

_______________________________________ _____________________________________

SCHOOL SCHOOL STAMP OR EMBOSSED OFFICIAL SEAL

_______________________________________ _____________________________________

SCHOOL ADDRESS SIGNATURE AND TITLE OF SCHOOL OFFICIAL

HOME-SCHOOL VERIFICATION FORM

This section must be completed by the coordinator of home-instruction in the county where the student resided and must

be embossed with the home-school office or school district stamp or official seal.

DATE____/_____/_____

month day year

Our records indicate that: Full Name ________________________________________________, whose

birth date is ____/_____/________ is registered with the ___________________________________

month day year (Name of Local System)

Department of Education as being home schooled from _____/_____/______to ____/_____/________

month day year month day year

There is no indication of transfer of records to any other secondary school.

_____________________________________________________________________

SIGNATURE AND TITLE OF COORDINATOR OF HOME INSTRUCTION

_________________________________________________

LOCAL EDUCATION AGENCY STAMP OR EMBOSSED OFFICIAL SEAL