High School Equivalency Registration 2022-2023
FOR AGE 21 AND OVER.  Please answer the following questions needed for intake.  ALL INFORMATION IS CONFIDENTIAL BUT REQUIRED FOR INTAKE.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Middle Initial
Last Name *
Date of Birth (month/day/year) *
MM
/
DD
/
YYYY
Address (# Street, Apt) *
City *
Zip Code *
Cell Phone Number (include area code) ###-##-#### *
Gender *
Have you ever taken and/or passed any Regents exam? *
Have you ever taken and/or passed any section of the TASC or GED exam (2002 to present)? *
We offer classes at various times.  Please let us know what time is best for you to attend class. (Check all that apply.) *
Required
What form of transportation will you use to attend school? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy