Diploma and GED Prep Program Interest Form

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Please provide the information in this form and we will contact you about enrolling in our High School Diploma or GED Test Prep classes.

Have you taken classes at Fremont Adult School before? *

Yes

What is your first name? *

What is your last name? *

What is your middle name or middle initial? *

What is your date of birth? *

YYYY

What is your email? *

What is your primary phone number? *

What is your secondary phone number? (if applicable)

What city and state do you live in? *

What is your gender? *

Female

Male

Non-Binary

Are you interested in earning your high school diploma or your GED Certificate? *

High School Diploma

GED Certificate

Not sure which one

Which high school(s) did you attend and in what city and state are they located? *

Have you taken any GED Subject Exams? If yes, which subject exams have you taken? Which subject exams have you passed? *

What is your goal after earning your High School Diploma or GED Certificate?
*

How did you hear about our program?

Submit

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