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G.E.D®
PROGRAM REGISTRATION
To register, please take the time to fill out the information below.
First Name
Last Name
Email
Address
Phone
Birthday
Who can we call if we cant reach you?
Their phone number
Gender
Choose an option
Female
Male
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Race
Choose an option
Black
White
Latino/Hispanic
Other
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Did you serve in the military?
Choose an option
Yes
No
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If you served in the military, which branch?
What was the last grade you completed? (required)
What is the name of the last school you attended? (required)
Were you in special classes?(required)
Choose an option
Yes
No
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Have you attended Thea Bowman Center in the past? (required)
Choose an option
Yes
No
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What are your learning goals? (Check all that apply) (required)
Get my GED
Improve my learning
Attend College
Go to trade school
Keep current job
Get a better job
If you have attended Thea Bowman Center in the past, what was the date you last attend?
Choose an option
Yes
No
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Have you attended GED® classes at another site? (required)
Choose an option
Yes
No
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If you attended GED® classes at another site, what was the name of the organization?
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