Adult Ed & ESL Interest Survey

Adult Ed & ESL | Interest Survey

Adult Education and English as a Second Language
FCC Adult Education has GED (High School diploma) and ESL (English) classes. We have classes throughout the year. Complete this form, and we will contact you with additional information for an orientation.

Please be patient. We currently have a waitlist for orientations and classes.

For assistance with the form, visit us Monday – Friday between 8:30 AM – 4:00 PM. Our office is in the Conference Center (Building E) room E102. You may call us at 240.629.7962.

Thank you. We look forward to meeting you!
Name*

First NameLast Name
Mobile Phone Number*

Area CodePhone Number
Additional Phone Number (Optional)

Area CodePhone Number
Email Address*
example@example.com
What is the ZIP code of your home address? *
example: 21701
What is your age?*
Adult Education (GED & Basic ESL) is for students age 18 and older.

If you have questions about Frederick County Public Schools, please call 301-696-6831. If you live outside Frederick County, browse the Internet for "high schools near me" to find a local school.
Do you live in Maryland?*

YesNo
Adult Education (GED & Basic ESL) is only for students who live in Maryland.

If you are interested in ESL, you MAY be able to participate in Targeted or Academic ESOL. Please email esl@frederick.edu to ask about enrollment. NOTE: As of Fall 2023, due to high demand, ESL is prioritizing service to Frederick County residents. If you live in another county, please seek a program there - all Maryland counties have local programs.
Are you an au pair, or do you have a J-1 or an F-1 Visa?*

YesNo
J-1 and F-1 Visa holders are not eligible for Adult Education classes.

You may also have credit requirements which can only be met in other programs. You may be able to participate in Targeted or Academic ESOL. Please email esl@frederick.edu to ask about enrollment.
Please indicate your highest level of education. (this does NOT include English classes)*

I have not attended schoolElementary SchoolMiddle SchoolSome High School - but no high school diplomaHigh School GraduateSome College or UniversityCollege or University GraduateGraduate School (Advanced Degree)
Did you attend the highest level of school...?*

in the United Statesoutside the United States
Please indicate ALL the FCC programs you are in now or have been in recently (within 3 years):*

ESL BeginningESL IntermediateESL AdvancedTargeted ESLAcademic ESOLAdult Basic Ed/GEDNon-credit ReadingNon-credit MathI am a new student
What is your native language?*
Have you taken placement tests at FCC (Accuplacer or Accuplacer ESL)?*

YesNo
Which Accuplacer test(s) have you taken and what were your scores?

What is your usual work schedule? (you can choose more than one answer)*

I am not working right now, but I'm looking for a jobI am not working right now, and I do NOT plan to begin a job soonI usually work weekday mornings (weekday means Monday, Tuesday, Wednesday, Thursday, and /or Friday)I usually work weekday afternoonsI usually work weekday eveningsI usually work at night (overnight)I usually work SaturdaysI usually work SundaysOther
What is your career (job) experience in the United States? *
What is your career (job) experience in your native country?
What class format do you prefer? Note: your preferred format may not be available for all programs, levels, or schedules*

I prefer in-person classes on campus.I prefer online classes via Zoom.
What kind of classes are you interested in (check all that apply)*

English as a Second Language (ESL for English language learners)English for Careers: Healthcare or BusinessAdult Education (GED for high school completion)Other
Which English for Careers class are you interested in attending (if available)?

HealthcareBusiness/Finance/AdministrativeIT (Information Technology)EducationOther
If you need accommodations or special support to participate in orientation & classes, please describe your need(s) here so we can refer you to the right service.
Do you need childcare to attend English class?*

No, I do not have childrenNo, I have child(ren), but I have arranged my schedule and/or childcareYes; I am working on a plan to arrange childcare with friends or familyYes, and I need help to find childcare
Do you have a child under the age of 3 years old?*

Yes (you can answer yes if you are pregnant with your first baby)No
Are you interested in attending a daytime class where your child would attend childcare while you attend English class? (Space is limited and participation in parent education is required)

YesNo
Thank you for your interest. If you have any questions, please feel free to contact us.

Adult Education and GED
frederick.edu/AdultEd • 240.629.7962 • AdultEd@frederick.edu

English as a Second Language (ESL)
frederick.edu/ESL • 240.629.7962 • ESL@frederick.edu.
Frederick Community College (FCC) prohibits discrimination against any person on the basis of age, ancestry, citizenship status, color, creed, ethnicity, gender identity and expression, genetic information, marital status, mental or physical disability, national origin, race, religious affiliation, sex, sexual orientation, or veteran status in its activities, admissions, educational programs, and employment. FCC makes every effort to accommodate individuals with disabilities for College-sponsored events and programs. If you have accommodation needs or questions, call 301-846-2408. To request a sign language interpreter, visit fcc-interpreting.genbook.com. If you have interpreting related questions, email Interpreting@frederick.edu. Sign language interpreters will not be automatically provided for College-sponsored events without a request for services. To guarantee accommodations, requests must be made at least five workdays in advance of a scheduled event. If your request pertains to accessible transportation for a College-sponsored trip, submit your request at least 21 calendar days in advance. Requests made less than 21 calendar days in advance may not be able to be guaranteed.
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Adult Ed & ESL | Interest Survey

Adult Education (GED & Basic ESL) is for students age 18 and older.

Adult Education (GED & Basic ESL) is only for students who live in Maryland.

J-1 and F-1 Visa holders are not eligible for Adult Education classes.