GED Program Application Form

GED Program Application Form

Complete the required details to apply for the GED program.
Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Social Security Number
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Government‑issued photo ID

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Gender
Race/Ethnicity
Are you currently employed?
Household income
Are you a veteran?
Are you disabled?
What is the primary language you speak?
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What is the highest grade level you completed
Upload a copy of your transcript

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Upload current Resume

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Have you previously attempted the GED exam?

FERPA Policy
CG Charitable Services (“CGCS”) is committed to protecting your privacy and maintaining the confidentiality of your educational records. Although CGCS is a nonprofit organization, we voluntarily follow the Family Educational Rights and Privacy Act (FERPA) standards to safeguard your information.

1. What Information We Collect
CGCS collects information needed to provide GED preparation services and meet state reporting requirements. This includes:

Identity information (name, date of birth, ID verification)
Contact information (address, phone, email)
Demographic information (gender, race/ethnicity, veteran status, disability disclosure—optional)
Education history and transcripts
Assessment scores (literacy, numeracy, TABE, CASAS)
Attendance and progress records
Case management notes
Career pathway and employment information

2. How We Use Your Information
Your information is used to:

Provide GED instruction and academic support
Determine placement and create your Individual Learning Plan (ILP)
Track progress and attendance
Report required data to state or federal agencies (if applicable)
Coordinate referrals to workforce or community partners
Improve program quality and services
CGCS does not sell or share your information for marketing purposes.

3. When Information May Be Shared Without Consent
FERPA allows certain disclosures without written consent. CGCS may release information only to:

CGCS staff with a legitimate educational need
Another school or testing center where you enroll or test
Federal or state agencies conducting audits or evaluations
Emergency personnel during health or safety situations
Courts or legal authorities with a valid subpoena
Financial aid or scholarship agencies
Accrediting or oversight organizations
Approved community partners providing direct educational or workforce services
All disclosures are logged as required by FERPA.

4. Directory Information (Optional Release)
CGCS may identify the following as “directory information”:

Name
Email address
Enrollment dates
Program participation status
You may opt out of directory information release at any time by submitting a written request.

5. Your Rights Under FERPA
You have the right to:

Inspect and review your education records
Request corrections to inaccurate or misleading information
Request a hearing if a correction is denied
Provide consent before CGCS releases personally identifiable information (except as allowed above)
File a complaint with the U.S. Department of Education
Family Policy Compliance Office U.S. Department of Education 400 Maryland Avenue, SW Washington, DC 20202

6. How We Protect Your Information
CGCS uses administrative, physical, and technical safeguards to protect your records:

Locked storage for paper files
Password‑protected digital systems
Limited access for authorized personnel only
Secure data transmission practices

7. Acknowledgment of Receipt
By signing below, you acknowledge that you have received and reviewed the CGCS FERPA‑Aligned Privacy Disclosure.
Name

First NameLast Name
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Media Release Form
CG Charitable Services (“CGCS”) occasionally captures photos, videos, and testimonials to highlight student achievements, promote educational programs, and share community impact. This Media Release Form explains how your image, voice, or statements may be used and gives you the option to grant or deny permission.

Your participation is voluntary, and your decision will not affect your enrollment or access to services.

1. Purpose of Media Use
CGCS may use photos, videos, or statements for:

Program promotion and outreach
Social media posts
Website content
Grant applications and reports
Community presentations
Printed materials (flyers, brochures, newsletters)
CGCS will never sell or misuse your image or personal information.

2. What May Be Collected
If you grant permission, CGCS may collect:

Photographs
Video recordings
Audio recordings
Written or spoken testimonials
Group or classroom images
No confidential educational information will ever be shared without your written consent.

3. How Media May Be Used
Your media may appear in:

CGCS social media platforms
CGCS website
Program brochures or flyers
Annual reports
Grant proposals
Community events or presentations
CGCS will ensure all media is used respectfully and appropriately.

4. Your Rights
You have the right to:

Decline media participation
Withdraw consent at any time (future use only)
Request removal of media from CGCS platforms when feasible
Ask questions about how your media will be used
Please select one option:
Name

First NameLast Name
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Signature (If under 18)

Code of Conduct
CG Charitable Services (“CGCS”) is committed to providing a safe, respectful, and productive learning environment for all students, staff, and volunteers. By enrolling in the GED Preparation Program, you agree to uphold the standards outlined in this Code of Conduct.

1. Respectful Behavior
All students must:

Treat peers, instructors, and staff with respect
Use appropriate language at all times
Avoid disruptive, aggressive, or threatening behavior
Respect differences in background, identity, and ability
Harassment, bullying, or discrimination of any kind is strictly prohibited.

2. Attendance & Participation
Students are expected to:

Attend scheduled classes and tutoring sessions
Arrive on time and prepared to learn
Notify staff in advance of absences when possible
Actively participate in lessons, assessments, and activities
Repeated unexcused absences may result in removal from the program.

3. Academic Integrity
Students must:

Complete their own work
Avoid cheating, plagiarism, or falsifying documents
Follow all testing rules and instructions
Violations may result in disciplinary action or dismissal.

4. Technology & Device Use
Students agree to:

Use CGCS computers, tablets, and internet access responsibly
Access only appropriate educational content
Avoid damaging equipment or altering settings
Refrain from recording staff or students without permission
Misuse of technology may result in loss of access.

5. Classroom Conduct
Students must:

Follow instructor directions
Maintain a quiet and focused learning environment
Keep food and drinks away from computers
Use break areas appropriately
Disruptive behavior may result in removal from the classroom.

6. Safety & Facility Rules
Students agree to:

Follow all safety instructions
Keep personal belongings in designated areas
Refrain from bringing weapons, drugs, or alcohol onto the premises
Report unsafe conditions or concerns to staff immediately
Violations may result in immediate dismissal.

7. Professionalism & Program Representation
Students are expected to:

Represent CGCS positively during off‑site activities
Dress appropriately for learning and workforce‑readiness events
Communicate respectfully with partners, employers, and volunteers

8. Consequences for Violations
Depending on the severity of the violation, consequences may include:

Verbal warning
Written warning
Meeting with program staff
Temporary suspension
Removal from the program
Serious violations (violence, threats, illegal activity) may result in immediate dismissal
Name

First NameLast Name
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Signature (If under 18)

Acknowledgment of Program Policies
By enrolling in the CG Charitable Services (“CGCS”) GED Preparation Program, you acknowledge that you have received, reviewed, and understand the policies and expectations outlined in the intake packet. These policies are designed to ensure a safe, respectful, and productive learning environment for all students, staff, and volunteers.

This acknowledgment covers the following documents:

FERPA‑Aligned Privacy Disclosure
Media Release Form
Student Code of Conduct
Technology Use Agreement
Attendance & Participation Policy
Safety & Emergency Procedures
Program Expectations & Completion Requirements
Please read each policy carefully before signing below.

1. Student Responsibilities
By signing this form, you agree to:

Follow all CGCS program policies and procedures
Maintain respectful behavior toward staff and peers
Participate actively in classes, tutoring, and assessments
Use CGCS facilities and technology responsibly
Communicate with staff regarding absences or concerns
Uphold academic integrity and honesty
Support a safe and positive learning environment

2. Program Commitments
CGCS agrees to:

Provide high‑quality GED preparation instruction
Maintain a safe and supportive learning environment
Protect your privacy and educational records
Offer academic, career, and case management support
Communicate clearly regarding program expectations and updates

3. Policy Updates
CGCS may update policies as needed to maintain compliance with state or federal guidelines. Students will be notified of any changes, and updated policies will be made available upon request.

4. Acknowledgment & Agreement
I acknowledge that I have received and reviewed all CGCS program policies listed above. I understand that compliance with these policies is required for continued participation in the GED Preparation Program.
Name

First NameLast Name
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent or Guardian Signature (if under 18)
Should be Empty:

GED Program Application Form

FERPA Policy

Media Release Form

Code of Conduct

Acknowledgment of Program Policies