CD Membership Registration

This is a secure registration form. Your information will not be shared with any other company and will be transmitted using a secure server.

The DCS GED Prep CD version includes the same features as the online version but is intended for people who do not have Internet access. All of the same practice lessons and computer-based practice test grading software from our web site are included on the CD. Use your computer and the DCS GED Prep CD to begin preparing for the GED Test now! No Internet access is required.
The DCS GED Prep CD will track the practice test scores and practice lesson activity for one student. The CD is available in English or Spanish.

Your CD membership packet will be mailed to you and will include:
   — The GEDonline CD described above
   — Two computer-based practice tests
   — Fully updated for the 2014 GED test
   — Practice test scoring and activity reporting for one student

The cost of a CD membership is $65.00 USD. ($68.58 for Wisconsin residents)

Computer minimum system requirements:
   — Windows Vista, 7, 8 (not available for MAC)
   — Internet Explorer web browser version 9
   — 500 MB Ram
   — 10 MB free disk drive space
   — Color monitor, 1028 x 600 resolution
   — DVD Rom drive
   — Printer, recommended for test repports
   — Sound card and speakers
   — Mouse and keyboard

NOTE: An additional $15.00 postage and handling charge will be added for mailing your registration packet outside of the United States.

Student Information (* = required field)

How did you find GEDonline?*
Which one?

First Name:*

Last name:*

Address:*

Apartment or Lot Number:*

City:*

State:*

Country(if outside of USA)*

Zip Code:*

(Area Code) and Phone Number:*

Email Address:

Birthday(mm/dd/yyyy):

Month:

Day:

Year:

Social Security Number:

Last Year of school:

	White	Black	Hispanic	Native American	Asian	Other
Ethnicity:

	Male	Female
Gender:

	Yes	No
Did you attend any Special Education classes?

If there is any other information you want to share, please do so in this box.

Why do you want your GED?

Which version of the GEDonline CD would you like?
English language version:
Spanish language version:

How many GEDonline CD memberships would you like?
Enter quantity here:

Method of Payment (You must select one method of payment*)

Credit Card	Mail a Check	Mail a Money Order	Purchase Order	PayPal

Fill in the information required for the payment method you selected*:

1. Credit Card

Card Number:

Expration Date:

Month:

Year:

Cardholder's Name:

	Master Card	Visa	American Express	Discover
Card Type:

2. Mail a Check

Make your check payable to DCOMS-SP and mail it to:
Diversified Computer Services
PO Box 2199
Kenosha WI 53141-2199

3. Mail a Money Order

Make your money order payable to DCOMS-SP and mail it to:
Diversified Computer Services
PO Box 2199
Kenosha WI 53141-2199

4. Purchase Order

Purchase order number:

Your purchase order can be faxed to 267-654-6979 or mailed to:

Diversified Computer Services
P.O. Box 2199
Kenosha, WI 53141-2199

The purchase order should list the student name and ID number. When your purchase order is received, your registration packet will be mailed and you will be invoiced.

5. PayPal

You can use your existing PayPal account or create a new PayPal account to pay for your GEDonline membership. After you submit this registration form, you will see a PayPal button on your confirmation page. Click the PayPal button to complete your payment.

After completing this form, please click Submit Form ONLY ONCE.
(If the Internet is slow, it may take several minutes to register. Please be patient.)
Your information will be transmitted via a secure server to ensure your privacy.