LaPorte County Adult Education Request Information 
Fill out the form below to request more information regarding the LaPorte County Adult Education HSE Program.
Sign in to Google to save your progress. Learn more
Email *
Your Name *
Age *
Do you have or are you able to obtain a valid Indiana State ID? *
Phone Number *
Last School Attended *
I am interested in... (check all that apply) *
Required
Desired Location (select all that apply)
How would you like to be contacted? *
Required
Comments or Questions
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Michigan City Area Schools.

Does this form look suspicious? Report

Google Forms