Duluth Adult Education - DAE - Step 1 Registration Form
Thank you for your interest in furthering your education with us here at DAE!

There are 2 Steps to complete your registration.

Step 1: Complete this form.

Step 2: In person registration required.

PLEASE CHECK YOUR EMAIL FOR INFORMATION ON HOW TO COMPLETE YOUR REGISTRATION.

 After you submit this form someone from our office will email you to give you information on Step 2 to complete your registration.  
  • Please make sure your email and phone number are correct. 
  • Please check your email in the next few days to make sure you receive the information on how to complete your registration
  • Please note, DAE is located at 325 W. 1st St., 3rd Floor, Duluth, MN 55802 

If you have questions contact 218-336-8725 or dae@isd709.org. 
Thank you!

Sign in to Google to save your progress. Learn more
1. Which program are you interested in? *
2. If you are interested in a specific class, career pathway, or opportunity, please enter it here.  If no, skip to next question.

You can find all of our opportunities by clicking here.
For example:
Ability to Benefit
English Conversation Class
English Vocab for Driver's Manual
College Prep Math Essentials 1
TEAS Exam Prep
Driver's Written Exam Prep
Paraprofessional


3. Last Name *
4. First Name *
5. Middle Name
6. Nick Name/Preferred Name
7. Pronouns (she/her, he/him, they/them, etc.)
8. Street Address *
9. City, State, Zip Code, County

(e.g. Duluth, MN, 55802, St. Louis County)
 *
10. Primary Phone *
11. Email *
12. Date of Birth *
MM
/
DD
/
YYYY
13. Age
Please note: if you are 17 or 18 years old an age waiver is required to take your GED tests. If you have questions contact us at 218-336-8725. Thank you.
14. Gender: *
15. What is your country of birth? 
16. What is your primary language? For example, English, Spanish, Swahili, Russian, Mandarin, etc.
17. Hispanic *
18. Race (Choose only one) *
19. Work Status  (Choose only one) *
20. Do you receive public assistance? (Choose only one) *
21. Highest Formal Education (Choose only one) *
22. Education Location *
23. Factors that challenge you to meet your educational or career goals  (Check all that apply) *
Required
24. Are you associated with a person or agency who assists with some or all of your needs? (Example: group home, county case manager, social worker, vocational counselor, etc.)
Clear selection
25.  If you answered "Yes" above please provide:

1. Name of the person or agency
2. Address
3. Phone number
4. Email

Please review our student contract - click here - with your case manager/social worker/counselor to make sure the program is a good fit for you.

We will ask you to sign a release of information to allow DAE to communicate with them.
26. Are you subject to a guardianship that affects your ability to enroll in educational services, enter contracts, or consent to a release of information?
Clear selection
27.  If you answered "Yes" above please provide:

1. Name of the guardian
2. Address
3. Phone number
4. Email
28. Are you the caregiver/parent/guardian for a student(s) enrolled in K-12, Pre-school, or ECFE through Duluth Public Schools?
Clear selection
29. Which items below would help support you meeting your educational or career goals? (check all that apply)
30. How did you hear about our program?
Clear selection
31. Social Security Number: Providing your SSN helps us meet state and federal reporting requirements.  We take every precaution to protect your privacy.
32. Tennessen Warning: Some of the information requested on this application may be private data under the Minnesota Government Data Practices Act.  Duluth Public School (DPS) is requesting this information to determine your eligibility for and enroll you in adult education, and if appropriate, coordinate support with other individuals or entities.  You are not required to provide the information requested on this application.  If you refuse to provide answers to the required questions, DPS will not be able to determine your eligibility for and enroll you in adult education. If you refuse to provide responses to questions 24, 25, 26, 27, 28, 29, 30, you may still be enrolled in adult education, but DPS will not know of others with whom it can coordinate support.  The information provided on this application will be accessible to DPS employees who have a work-related need to know the information, the Minnesota Department of Education, the Minnesota Department of Human Services, and St. Louis County. 

I have read this information:
 *
PLEASE NOTE: YOUR REGISTRATION IS NOT COMPLETE.

TO COMPLETE YOUR REGISTRATION, YOU MUST COMPLETE STEP 2 IN PERSON FOR:

GED/Diploma
Core Skills
English Language (ESL/ELL)

PLEASE CHECK YOUR EMAIL FOR A REMINDER OF YOUR OPTIONS TO COMPLETE STEP 2 OF REGISTRATION. 

Please select the option below that works best for you to complete in person Step 2 of registration:
 *
PLEASE NOTE: YOUR REGISTRATION IS NOT COMPLETE.  PLEASE CHECK YOUR EMAIL FOR INFORMATION ON COMPLETING YOUR REGISTRATION FOR: 

College Prep
Career Path

Someone from the DAE office will email you to give you more information to complete the registration process.

For College Prep Step 2 includes an additional registration with Lake Superior College.

For Career Path Step 2 is specific to the career path you are interested in and you will get more information from the email.

Thank you for taking the time to complete this form.  Someone from Duluth Adult Education will contact you by email.

DAE is located at 325 W. 1st St., 3rd Floor, Duluth, MN 55802 

If you have questions please contact 218-336-8725 or dae@isd709.org. 

Welcome!

Be sure to click the submit button below.  Thank you!


Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Duluth Public Schools.

Does this form look suspicious? Report

Google Forms