East Side Adult Education ABE/ASE/CTE/GED Registration Form - Fall 2020
Student Information - Please take time to complete the information below.
Email address *
Registration Status *
I would like to enroll in the following: *
Required
I would like to enroll in ONE of the following session *
Adult Education Identification Number or Not Applicable (NA) *
Name: First, Middle, Last *
Address: Street *
City *
State *
Zip Code *
Primary Contact Number *
Secondary Contact Number
Emergency Contact: Name *
Emergency Contact: Relationship *
Emergency Contact: Phone Number *
Gender *
Date of Birth *
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DD
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Are you Hispanic or Latino? *
Race (check all that apply)
Native Language (check one)
Highest Year of Schooling Completed (check one)
Majority of my school was outside of the U.S
Did you attend high school at East Side Union High School District?
Clear selection
If yes, write the name of the high school or write NA *
Highest Degree Earned ( check one)
Earned outside of U.S *
Please continue to complete more information. My attainable goals within the program year. Please select two.
Employment Status
Employment Barriers (Mark all that apply)
By my typed name below, I verify that all the information entered above is true and correct to the best of my knowledge. *
Registration Completion Date *
MM
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DD
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YYYY
Thank you! To be officially registered please call the office ( 408-928-9300) for the counseling appointment or to take the placement test. Please click submit below.
Submit
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