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Registracion de GED en Espanol
Please note: The CA Department of Education requests demographic data for all adults who enroll in classes. This information may assist our school in qualifying for State and Federal Funds. Information is confidential and only reported collectively.
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* Indicates required question
Name / Nombre:
*
Your answer
Address / Direcion:
*
Your answer
City, State, Zip/Ciudad, Estado, Codigo Postal
*
Your answer
Birth Date / Fecha de Nacimiento:
*
Your answer
Social Security Number (Optional) / Numero Seguro Social (Opcional)
Your answer
Gender / Genero
*
Male / Maculino
Female / Femenino
Home phone / Telefono de Casa:
*
Your answer
Work Phone / Telefono del Trabajo
Your answer
Cell Phone / Telefono Celular
*
Your answer
Email / Correo Electronico:
Your answer
Highest Degree Completed /Grado Mas Alto Completado:
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None / Ninguno
High School Diploma / Diploma
GED Certificate / Certificado de GED
Technical Certificate / Certificado Tecnico
Some College (No Degree) / Algo de Universidad
AA/AS Degree (2 years of College) / AA/AS (2 anos de la Univerisdad)
My Degree was earned outside the US / Mi diploma fue obtenido fuera de los Estados Unidos?
*
Yes / Si
No
Work Status / Situacion Laboral:
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Not employed and not seeking work / No estan trabajando O buscando trabajo
Retired / Jubilados
Employed / Empleado
Umemployed / Desempleados
Ethnicity / Origen Etnico:
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Hispanic or Latino / Hispano O Latino
Not Hispanic or Latino / No Hispano O Latino
Race / Raza:
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Pacific Islander / Las Islas del Pacifico
Alaskan Native / Alaska Nativo
White / Blanco
American Indian / Indio Americano
Filipino / Filpino
Asian / Asiatico
Black or African American / Negro O Africano Americano
Total Years of School Completed? / Total de anos de escuela completados?:
*
Your answer
Majority of Schooling Outside United States? / Mayoria de escolaridad fuera de los Estados Unidos?
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Yes / Si
No
Is English your second Language?/ Es Ingles su segundo idioma?
*
Yes / Si
No
Do you have any Disabilities? / Tiene alguna incapacidad?
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Yes / Si
No
Marital Status / Estado Civil:
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Single / Soltero/a
Married /Casado/a
Primary Language? / Idioma Primario?
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English / Ingles
Spanish / Espanol
Vietnamese / Vietnamita
Chinese / Chino
Cambodian / Canboyano
Hmong / Hmong
Tagalog / Tagalog
Korean / Coreano
Lao / Lao
Farsi / Farsi
Russian / Ruso
Personal Status - Situacion Personal
*
Food Stamps/ Estampias
Family Eligible for Medi-cal/ Familia elegible para Medi-cal
TANF/CALWORKS Recipient/ Recipiente de TANF/Calworks
SSI Recipient/ Recipiente de Seguro Social
County General Assistance/ Asistencia General del Condado
Child eligible for free/reduced school Meals/Hijo/a elegible para almuerzo gratis o reducido
Family has housing assistance (Sec. 8)/ Asistencia de casa (Section 8)
Family receives energy assistance (LIHEAP)/ Asistencia de energia (LIHEAP)
Receiving CA training Benefits (EDD)/ Recibes beneficios de entrenamiento de CA
Referred by Rehab/ Referido por rehabilitacion
Referred by Bureau of Indian Affairs/ Referido por la oficina de asuntos Indios
Veteran/ Veterano
Homeless/ Sin Hogar
Single Parent/ Padre Soltero
Disabled/ Descapacitado
Rehabilitation Client/ Cliente de Rehabilitacion
Displaced Worker/ Trabajador desplazado
Displaced Homemaker/ Ama de casa desplazada
Migrant/ Migrante
Limited English Proficient/ Dominio limitado del Ingles
Basic Skills Deficiency/ Deficiencia limitado de habilidades basicas
Not Applicable/ No aplica
Required
Are you taking this class to help your child in school? / Esta tomando este clase para ayudar a su hijo/a en la escuela?
*
Yes / Si
No
Emergency Contact Name / Nombre de Persona de Emergencia:
*
Your answer
Emergency Contact Phone Number / Telefono de Persona de Emergencia:
*
Your answer
Emergency Contact Relationship / Relacion de Persona de Emergencia:
*
Your answer
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