Spanish (Latin America)
English Class Registration
Please complete the following form in order to start the process of enrolling in classes with Washington Township Adult Education. If you need help filling out this form, we can help you when you come in person to orientation or over the phone. You can translate this form into your native language using the button in the upper right.
What program at Washington Township Adult Education are you interested in enrolling in?
English Classes (for non-native English Speakers)
Social Security Number or ITTN
(If no SSN, fill in all ones.)
Street Address Line 2
State / Province
Postal / Zip Code
County of residence
i.e. Marion County
Please enter a valid phone number.
Your Date of Birth
Emergency Contact Phone Number
Please enter a valid phone number.
Emergency Contact Name
Are you OVER 18 years old?
Prefer not to say
Are you a US Citizen?
Currently in application process
When did you come to the United States?
If you are not a US citizen, do you have a work permit?
Working on it
Are you currently employed?
Not in the labor force
If you are not in the labor force, what best describes your situation?
I am not eligible for work in the USA
I am retired
I am a homemaker
I am disabled
Where do you work?
What is your job title?
Do you work full-time or part-time?
When did you start working at your job?
What is your current school attendance status?
In high school
Not in school
What is the highest level of schooling you received?
Grades 9-12 NO DIPLOMA
Certificate of Completion (Disability/IEP)
High School Equivalency
High School Diploma
Some Post-secondary (NO DEGREE)
Certification or other non-degree technical program
Was the last school you attended in the US?
Are you currently enrolled in school?
If yes, what is the name of your current school?
Do you have any dependents (children under 18) or are you a dependent (under 18)?
How many people live in your house, including yourself?
What is your annual household income?
Have you previously been a student at Washington Township Adult Education?
How did you find out about Washington Township Adult Education?
I am a returning student
Friend or Family
Google online search
Facebook or other Social Media
Select any of the following demographics that apply to you:
Live in an urban area (in the city or within 50 miles of it)
Live in a rural area (outside of the city)
Currently laid off or terminated
Non-English used at home
Active Military (or military spouse)
Cultural Barriers to Employment
I am enrolling in an adult basic education (ABE) program. This ABE program works with the following programs and agencies to help students improve their skills and earn better jobs: other state-funded adult education programs; WorkOne offices and job training programs; public and private colleges; state executive offices, departments, and agencies (including the Indiana Department of Workforce Development); and the division of Adult Education and the Indiana Department of Education. By signing this form, I understand and agree to the following: DWD use of directory information (name, address, birth, and social security number) to match test score records, wage information, and college/training program enrollment records that assist the state to evaluate and improve its programs and to report results to the federal and state government and the sharing of information between the agencies and programs listed above. This information may include my name, enrollment information, education/career goals, test scores, and employment history. The information will be kept strictly confidential and will be used for program administration, research, and evaluation purposes. By filing in your full name below you are agreeing to these terms. Please type your name and date below. Students under the age of 18 must have this consent form signed by the student’s parent or guardian.
I give WTAE permission to share photo images and student approved testimonials on WTAE social media platforms, website, and partnering state agencies.
There is a $20 non-refundable registration fee due on the day of your intake. How would you like to pay?
Please select the intake date you plan on attending:
October 22,2021 @ 9:45 am
October 25,2021 @ 5:30 pm
December 17,2021 @ 9:45 am
December 20,2021 @ 5:30 pm
Should be Empty: