KCET Program: GED Application Form
DEMOGRAPHICS AND CONTACT INFORMATION:
First Name
Middle Initial
Last Name
Preferred Name
Date of Birth
Gender
Male
Female
Non-Binary
Social Security Number
Social Security Number Unavailable
Please select...
Yes / Sí
No / No
Mailing Address
City
State
Zip Code
Personal Email Address
Country Code
Cell Phone
Do not enter - or ()
Country Code
Home Phone
Do not enter - or ()
Preferred Method of Communication
Please select...
Phone
Text
Email
DEMOGRAPHICS AND CONTACT INFORMATION:
Emergency Contact Information
Emergency Contact (Legal Name)
Country Code
Emergency contact phone number
Ethnicity
Race
White
Native Hawaiian or other Pacific Islander
Black or African American
Asian
American Indian or Alaska Native
If you marked "Other" for language please specify
Native Language
English
Spanish
Other
Prevalent language spoken in the home as a child
GED Class Selection
Select your preferred Term:
MARK THE INSTRUCTIONAL PROGRAM YOU WOULD LIKE TO ENROLL IN
Please Select Your Preferred Course Delivery
GED Virtual
GED Morning
GED Evening
Hidden
Applying To
Start Term
PREVIOUS EDUCATION
If 50% or more of the above schooling occurred outside the US Mark YES.
Yes
No
Highest Grade Level Completed: (grade level by #)
Highest Diploma / Degree Earned
Please select...
None / Ninguno
GED Certificate / Certificado de GED
High School Diploma / Diploma de escuela secundaria/preparatoria
Technical Certificate / Certificado técnico
Some College, No Degree / Algunos estudios universitarios, sin titulación
A.A /A.S. Degree / Grado Asociado
4-yr. College Graduate / 4 años de Estudios Universitarios, graduado
Graduate Studies / Estudios de postgrado
Other Diploma/Degree /Otro Diploma/Titulo
I earned the above outside the U.S.
Yes
No
Personal Educational Goals
Select one primary goal and one secondary goal
For Long term and Short term Goals: Please select one for each and ensure that each goal is unique
Short-term Goal – Choose 1
Please select...
Go to college
Find a better career
Relocate to a different city
Retain a job
Work-based project
Family goal
Get US Citizenship
Join the military
Enter short-term training
Get off public assistance
Obtain a GED
Long-term Goal – Choose 1
Please select...
Go to college / Ir a la universidad
Find a better career / Conseguir una mejor carrera
Relocate to a different city / Reubicarse en una ciudad diferente
Retain a job / Conservar un empleo
Work-based project / Proyecto de trabajo
Family goal / Objetivo de familia
Get US Citizenship / Obtener la ciudadanía en EU
Join the military / Unirse a las fuerzas militares
Enter short-term training / Para cursos breves
Get off public assistance / No depender más de la asistencia püblica
Other Attainable Goal
How did you hear about this program?
Advertisement
Education Fair
Family Member
Flyer
Former/Current Student
High School Visit
Social Media
Word of Mouth
Other
Other
Otro
Contact Information