Adult Education Orientation Registration
Complete required fields to confirm your Orientation attendance.
First Name
Your answer
Last Name
Your answer
Social Security Number
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age
Your answer
Female or Male
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Primary Phone Number
Your answer
Alternate Phone Number
Your answer
Email Address
Your answer
Is student Hispanic Latino?
Ethnicity
Highest Degree or Grade Completed
Employed or Unemployed?
Place of Employment
Your answer
Job Title
Your answer
Location
I understand that New Student Orientation/Registration is from 9:00am-5:00pm and I am required to stay for the entire day.
I understand that I should bring my lunch and will not be able to leave campus.
I understand that I must have a Valid Government issued ID Card & Social Security Number to complete Intake Assessment Test.
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