Arizona High School Equivalency: GED
Access Code Request
The purpose of this form is to request an Access Code to create a Test-Taker Proﬁle on the MyHSE Arizona Web Portal.
⇒ Please clearly fill out Section 1.
⇒ Sign and date the form.
⇒ This form MUST be submitted with a clear and readable photocopy of a current valid government-issued picture
I.D. and through one of the following options listed below:
♦ By Email: email@example.com
♦ By Fax: (602) 542-0031
♦ In Person: Adult Education Services Walk-In Location at 1535 W Jefferson St. Phoenix AZ 85007
♦ Monday to Friday from 8:00am—4:30pm
♦ Please select one of two options below for the delivery of your ACCESS Code.
1. After 30 minutes of submitting the form, please call (602) 258-2410, option #2 to obtain the Access Code.
2. If you would like your ACCESS Code to be emailed, please provide your email address: _______________________.
Access Codes will not be given to 3rd parties***
⇒ Once you receive your Access Code, go online to https://myhse.azed.gov and select step 1 to “Create Your Account”.
Must be Completed by Former Test-Taker
Current Legal Name (REQUIRED, First, Middle, Last) Date of Birth (REQUIRED, month/day/year)
Name at Time of Test and Any Other Names Used (Required if diﬀerent than above) Social Security Number (last 4 digits)
XXX - XX -
Current Mailing Address, City, State, Zip Code Current Phone Number
( ) -
Approximate Testing Location Approximate Testing Date
Certification: “I hereby certify that all information provided is true, and I authorize the release of my official tran-
script or completion date to the requestor.” (Signature Required by FERPA Student Privacy Act)
Signature Date / /
⇒ DO NOT MAIL THE FORM.
⇒ If the submitted picture I.D. is not clear or readable, resubmission may be required.
⇒ If submitting the form by Fax, it is recommended to use the lightest setting.
⇒ Submitted requests are not kept for more than 2 business days.
Eﬀective and updated 07/24/2018
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