GED TRANSCRIPT AND/OR DIPLOMA REQUEST FORM

GED TRANSCRIPT AND/OR DIPLOMA REQUEST FORM

(Please print clearly) Surname : Previous Surname : Email : Complete Mailing Address : Postal Code :

First :

Middle :

Telephone (day) : Date of Birth :

day

month year

CHECK APPROPRIATE BOXES: GED Transcript (fee $5) GED Diploma (fee $10)

COMPLETE THIS SECTION ONLY IF YOU WANT THESE RESULTS SENT TO SOMEONE OTHER THAN YOURSELF.

Name of Person or Institution :

Mailing Address :

Postal Code :

Fax Number :

Provide copy for my records: yes no

Request and payment must be submitted to Service New Brunswick (SNB). Choose from the following options:

1. Online at snb.ca/gede 2. By telephone at 1.888.762.8600 3. In person at nearest SNB office

ADMINISTRATION FEES ARE NON-REFUNDABLE.

July 2018

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