HSE Student Application

HSE Student Application

Fill out the form carefully for registration. We will follow up as soon as possible. *Please note that our HSE tutoring sessions are taught only in English. If you are looking for ESOL classes, please click here to register.
Before beginning the application, please read the following statements. CHECK all of the statements that apply to you.*

I can commit to meeting with a tutor 1-2 times per week for 45-90 minutes at a timeI can commit to doing homework and having it ready for each tutoring sessionI am eager to earn my HSE diploma and am pursuing this degree on my own accord
If any of the boxes above are unchecked, please let us know what barriers may be in the way:
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Month-Day-Year
Mobile Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
E-mail Address*
example@example.com
Mailing Address*

Street Address

Street Address Line 2/Apartment #

CityState / Province

Postal / Zip Code
What is your primary language?*

EnglishSpanish*Portuguese*French*Arabic*Haitian Creole*Other*
*PLEASE NOTE: HSE tutoring sessions are taught only in English. If you are looking for ESOL classes, please click here to register.
What are your preferred pronouns?*

He/Him/HisShe/Her/HersThey/Them/TheirsOther
What is your availability for tutoring sessions?*

Weekdays Morning ZoomWeekdays Morning In Person at Beverly BootstrapsWeekdays Afternoon ZoomWeekdays Afternoon In Person at Beverly BootstrapsWeekdays Evening ZoomWeekends
When were you last enrolled in school?*
What is the last grade of school that you completed?*

Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12Other
What is the name of the last school you attended (School Name/City/State/Country)?*
Were you receiving Special Education accommodations?*

YesNo
If yes, do you have an IEP or educational testing reports to share?
The MA Department of Education Requires that each test taker present a valid, government-issued ID that shows your name in the English alphabet, your signature and your photograph. Do you have such identification?*
Please briefly explain why you are interested in the HSE program at Beverly Bootstraps:*
How did you hear about Beverly Bootstraps Adult Education programs?*

WebsiteFlyerNewspaperFriendOther
All of the information I have provided in the above application is true. I understand that just by completing this form, does not mean that I am accepted as a student.*

I agreeI do not agree
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