Mujeres Unidas Avanzando: Student Registration Form for Technology Classes
Our classes are from September to June. We accept new students at the beginning of each month if there is space available.

Please answer all questions as completely as possible.

Also, please note that is application is only for our Technology classes. If you are interested in our English (ESOL) classes, our HiSET (GED) Preparation classes or our job trainings (Home Health Aide, Clinical Medical Assistant, or Phlebotomy), you will find those applications at www.muaboston.org. Thank you!
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Email *
Today's Date: *
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Full Name (First and Last): *
This year, we have two technology classes: Basic Technology Skills/Introduction to Microsoft Office, and Microsoft Office Administration Training. Which class do you prefer? (You will need to complete a digital skills assessment before you can begin so we can be sure the class is the correct level for you.) *
Both classes are fully in-person at our school in Dorchester. Both classes are part of our day program, which is open to women only. Do you accept this? *
Is this your first time studying at MUA? *
If you answered "no" in the previous question, when was the last time you studied at MUA, and in which class?
How did you learn about MUA? Please check all that apply. *
Required
Were you referred to MUA by another organization? If yes, which organization? (For example: DTA, MassHire, a shelter)
Date of Birth: *
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Sex: *
Preferred pronouns: *
Address (Street): *
Address (City): *
Address (Zip Code): *
Phone Number: *
Email Address: *
Country of Birth: *
Languages Spoken: *
Current Employment Status: *
Emergency Contact (Name): *
Emergency Contact (Phone Number): *
What is your emergency contact's relation to you? (Husband, mother, friend, cousin, etc.) *
Disability Disclosure
This Adult Education Program does not discriminate on the basis of disabilities. Applicants may but do not have to disclose disabilities. Applicants who do disclose disabilities may be entitled to reasonable accommodations.
Do you understand that you are not required to disclose any disabilities? *
Do you wish to disclose a disability?
Do you understand that disclosing this disability may make you eligible for reasonable accommodation?
Clear selection
Do you wish to request any specific accommodations at this time?
Clear selection
Is the documentation of your disability up to date?
Clear selection
Volunteer Work
Some students at MUA serve in the school as volunteers in many different ways, in addition to taking classes. If you would like to participate as a volunteer, please complete the following question.
Are you interested in learning more about how to volunteer at MUA? *
Donation
All classes and services are free, but we do accept donations from students who are willing and able to contribute. If you are interested in making a donation, you can do so at: https://muaboston.org/support-mua/ through Paypal. A donation is not mandatory, and students can still participate in the program if they are unable to make a donation. Thank you in advance!
"I hereby confirm that the information I have provided on this form is true and accurate to the best of my knowledge." Please type your full name to signify that you agree. *
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