Student Data sheet

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Student Data Sheet

Please complete this form to register for the GED Preparatory course beginning August 17, 2015. A non-refundable $20 deposit is required, the balance of $55 is due the first day of class. You will receive a confirmation email, once your deposit has been accepted.

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

What is your age? *

18-25 26-35 36-50 Over 50 Prefer not to say

What is your gender? *

Male Female

What was your last grade completed in High School *

12th Grade 11th Grade 10th Grade 9th Grade Did not attend High School

Have you taken the GED in the Past? *

Yes No

If Yes, What year did you take the test? *

If Yes, what subjects did you pass? *

What are your plans after passing the GED test? *

Enroll in a university or college Get a job/promotion Start my own business No plans at this time

Other *

Would you like assistance with your plans after passing the GED test? *

Yes No

Do you need assistance with developing or revising your resume *

Yes No

Is there any other vocational training needed? (i.e. Computer Skills, Microsoft Office, etc.) *

Yes No

If Yes, please briefly explain what additional training is needed. *

Do you have a laptop or tablet *

Yes No

If Yes, can you bring it to class when needed? *

Yes No

Please briefly describe your goals that you would like to accomplish in the near future (1-3 years). *

Submit

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