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D79 - Adult Education - Brooklyn
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Email
*
Your email
Last Name / Apellido
*
Your answer
First Name / nombre
*
Your answer
Address / Direccion
*
Your answer
Zip Code / Codigo Postal
Your answer
Birth Date / Fecha de Nacimiento (MM/DD/YYYY)
*
Your answer
Phone Number / Numero de Telefono
*
Your answer
Gender
Female
Male
Non-Binary/Gender Non-Conforming
Other:
Clear selection
Employment status
Employed Full-time
Employed Part-time
Unemployed
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Highest Grade completed in US
Your answer
Highest Grade completed in NYC
Your answer
Name of last School Attended (If NYC)?
Your answer
Years of Schooling in Other Countries
0
1
2
3
4
5
6
7
8
9
10
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Have you taken the GED or TASC exam before?
Choose
I completed school in another country
Yes, but did not pass all subjects
No
If yes, which subjects did you pass?
Math
Science
Reading
Writing
Social Studies
have not taken GED or TASC exam
Emergency Contact Name / Relationship Nombre de Emergencia / Relacion
Your answer
Emergency Contact Number / Numero de Contacto de Emergencia
Your answer
Which class would you prefer?
*
ESL- English as a Second Language
BE/GED - Basic Education/High School Equivalency
Sp. GED - Spanish High School Equivalency
CTE- Career and Technical Education
What best describes you, please select all that apply
I would like to earn GED
I would like to improve my English skills (ESL Class)
I am a native English speaker
I would like to earn Spanish GED
I am interested in OSHA-30 certification
I am interested in ServeSafe food certification
I am interested in Microsoft Office Computer classes (Word, Excel, PowerPoint)
Other:
Are you a parent or guardian of a child/children under 21?
*
Yes
No
Are you a Single Parent?
*
Yes
No
Race/Ethnic Identity
HIspanic/Latino(a)
Non-hispanic/Latino(a)
Clear selection
Race/Ethnic Identity (choose all that apply)
Native Hawaiian
Native American
Alaskan Native
Asian
Pacific Islander
African American
Afro Caribbean
African
Latino/a
White (non-Latino/a)
Other:
Are you age 21 and over?
*
Yes
No
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