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Adult Learner Registration
REGISTRATION IS NOW OPEN FOR OUR 2022-2023 SCHOOL YEAR. Please complete the following form in order to begin the process of enrolling with Washington Township Adult Education. Upon completion of your Registration, you will receive a confirmation email. If you do not see the email, please check your SPAM email folder before completing an additional registration. After you submit your registration, please call 317-259-5275 and ask for Intake Specialist to schedule your intake and testing.
I am enrolling in HSE prep classes to prepare for the HiSET test. Please DO NOT complete this form if you are needing English classes.
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HSE Prep Classes
Name
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First Name
Last Name
Social Security Number or ITTN
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(If no SSN, fill in all ones.)
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County of residence
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Please Select
Marion
Hamilton
Boone
Hendricks
Hancock
Other
Are you a citizen of the United States?
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Please Select
Yes
No
Currently in the application process
Other
Native Country
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What is your Native Language?
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When did you come to the United States?
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Month
-
Day
Year
Date
If you are not a US citizen, do you have a work permit?
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Yes
No
Working on it
Other
Student's Phone Number
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Please enter a valid phone number.
Emergency Contact Name
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First Name
Last Name
What is your relationship to your emergency contact
Please Select
Spouse/Partner
Brother/Sister
Family Relative
Friend
Other
Emergency Contact Phone Number
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Please enter a valid phone number.
Student's Email
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Confirmation Email
example@example.com
What is your Date of Birth?
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-
Month
-
Day
Year
Date
Are you over 18 years old?
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Yes
No
If you are 16 or 17 years old please print this Exit Form and have it completed by the High School you last attended. An Exit Form is required by the state for minors to enroll in Adult Education programs.
Gender
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Female
Male
Nonbinary
Prefer not to say
Ethnicity
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Hispanic
Other
Race
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American Indian
African American
Asian
Pacific Islander
White
Other
Are you currently employed?
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Yes
No (Unemployed, looking for work)
Not in the labor force
Other
When did you start working at your job?
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-
Month
-
Day
Year
Date
Where do you work?
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If you are not in the labor force, what best describes your situation?
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I am not eligible for work in the USA
I am retired
I am a homemaker
I am disabled
Other
What is the highest level of schooling you received?
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Grades 1-5
Grades 6-8
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
Bachelor's Degree
Associate's Degree
Master's/PhD
Other
Are you currently enrolled in school?
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Yes
No
If yes, what is the name of your current school?
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Was the last school you attended in the US?
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Yes
No
Select any of the following demographics that apply to you:
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Veteran
Disability (Physical/Mental)
Live in an urban area (in the city or within 50 miles of it)
Live in a rural area (outside of the city)
HIPP/SNAP Recipient
Low Income
Displaced Homemaker
Single Parent
Currently laid off or terminated
Claims Dependents
Foster Care
Homeless
Non-English used at home
Active Military (or military spouse)
Vocational Rehabilitation
Wagner-Peyser Employment
Migrant/Seasonal Farmworker
Ex-Offender
Cultural Barriers to Employment
Do you have any dependents (children under 18) or are you a dependent (under 18)?
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Yes
No
What is your annual household income?
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How many people are in your household?
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i.e. 3
Have you previously been a student at Washington Township Adult Education?
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Yes
No
How did you find out about Washington Township Adult Education?j
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Please Select
Facebook/Instagram
Employ Indy
Friend or Family
Google or Internet search
High School
Ivy Tech
Returning Student
Social Media
TV
Other
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.
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Signature of Student OR Parent/ Guardian if a minor
I give WTAE permission to share photo images and student approved testimonials on WTAE social media platforms, website, and partnering state agencies.
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Yes
No
Back
Next
Please select the location & class that you would like to attend the High School Equivalency classes.
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Please Select
Northview Middle School
Pike High School
St. Monica's Catholic Church
Noblesville First United Methodist Church
Lebanon Library
Virtual
Northview offers the following classes. Select preferred classes.
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Waitlist- Class FULL M/T/W/TH 9:30am-12:30pm
Waitlist- Class FULL T/TH 9:30 am - 1:00 pm
Coming Feb 6th M/W 9:30 am - 1:00 pm
Waitlist- Class FULL T/TH 5:30 pm - 9:00 pm
Waitlist- Class FULL M/W 5:30 pm - 9:00 pm (JEL)
Pike High School class
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M/W 5:30 pm - 9:00 pm
St. Monica's Catholic Church class
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M/W/F 9:30 am - 12:30 pm
John H Boner Community Center class
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M/W 9:30 am - 1:00 pm
Noblesville Schools Community Center class
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T/TH 5:30 pm - 9:00 pm
Noblesville First United Methodist Church class
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Waitlist - M/T/TH 12:00 pm - 2:15 pm
Lebanon Library class
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T/W/TH 10:00 am -2:00 pm
Virtual class. *In addition to class time, there is a weekly minimum of 1 hour of distance learning (self study) required for all Virtual classes.
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Waitlist- Class FULL T/TH 10:00 am - 1:00 pm
Virtual students must have access to a computer for TABE testing OR be able to come to Northview location whenever TABE testing is required.
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Yes, I have accesses to a computer and able to come to Northview for testing
Intakes are at our main location in Northview Middle School (8401 Westfield Blvd. Indianapolis, IN 46240.
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Call the office to schedule with an Intake Specialist 317-259-5275
There is a $20 non-refundable contribution that is collected on the day of your intake. Our classes are FREE. How will you be contributing at intake?
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Cash
Credit/Debit
Submit Registration
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