Adult High School Diploma Class Registration
Welcome! This form will give us the information we need to register you in our Adult High School Diploma class.
Our next classes will start on August 9, 2021. Which class are you interested in?
Clear selection
Our class might be taught online if we cannot meet in person. If class is online, here is a list of what you would need. Please check the items you have:
Social Security Number
Last Name
First Name
Middle Initial
Street Address
Zip Code
Primary Phone Number (XXX-XXX-XXXX)
Emergency Phone Number (XXX-XXX-XXXX)
Cell Phone Number (XXX-XXX-XXXX)
Prefer Text Message?
Clear selection
E-mail Address
Date of Birth (Month, Day, Year)
Clear selection
Maiden Name
Race (If Ethnicity is "Other", choose one of these
Native Country (leave blank if USA)
U. S. Citizen? (We gladly serve everyone.)
Have you attended MCCSC Adult Education classes before?
Medical concerns we should be aware of:
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