Form - Eaton RESA Adult Education New Student Interest Form

Student Information

Student's First name Please use your legal name.

Student's Middle Initial

Student's Last Name

Gender (required) Male Female Non-Binary Prefer not to answer

Student's Date of Birth

Phone Number

Email Address

Please attach a copy of your valid Michigan State ID or Drivers license (required)

Filename Size Status

0 b 0%

Education History

What was the last school you attended?

What was your reason for leaving?

What was the highest grade level you completed? (required) K-5 6-8 9 10 11 12

Did you receive any of the following:

Do you have any prior experience with the GED/HiSET®?

Goals and Support Needs

Do you need childcare services while attending classes?

Class Location Preference? (required) Delta Township District Library East Lansing Public Library Holt - Caterpillar Corner (Childcare Available) Westside Community YMCA (Childcare Available) Lansing - Capital Area Michigan Works! Grand Ledge Area District Library Mason Community Services Eaton Rapids - Greyhound Central St Johns - Briggs District Library Virtual

Is there anything that might make it harder for you to attend or succeed in classes? For example, transportation, mental health, physical health, housing, technology, work schedule, family responsibilities, etc.

What are your goals after you complete your GED/ HiSET®?

How did you hear about our program? (required) Billboard Word of Mouth Agency Referral Friend or Family Referral Facebook Website Google Other

If you answered other, please explain.

You will now be redirected to complete your Adult Learning Plan. *You must complete this in one sitting.* Please allow up to 30 minutes to complete this state required form. You will not be able to go back once you start it. Once you are ready, select "Proceed to step 2."