Pre-Registration ~ Spring 2022 ~ Family Literacy
PLEASE READ ALL DIRECTIONS CAREFULLY!

You are pre-registering for Spring 2022 Adult Education classes.

Please note that this pre-registration is only step one, and you will need to come in person to finalize your registration and to complete any required pre-testing.  You will choose the day, time, and location on the last question of this form.  If you do not keep your scheduled appointment, you will be removed from the registration and added to a waitlist.

Please complete all required questions and click "submit" when done.  

Classes are free for East Hartford residents, and non-resident charges are listed in the class descriptions below.  If these charges apply to you, payment is due at your appointment when you complete your registration and may be paid using cash only.

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I am registering for the following program(s) (choose all that apply): *
Required
First Name *
Last Name *
Middle Name
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Are you Hispanic/Latino? *
What is your race?  Check all that apply *
Required
What is the highest level of education you completed? *
Was your highest level of education completed in the United States? *
What is your employment status? *
Do you have any barriers to employment?  Select all that apply *
Required
How did you hear about our program? *
What is your street address? *
In what city/town do you live? *
What is your zip code? *
Home Phone Number (enter "none" if you do not have a home phone) *
Mobile/Cell Phone Number (enter "none" if you do not have a mobile/cell phone) *
Email Address *
Miscellaneous Characteristics (check all that apply): *
Required
You will need to finalize this registration in person - THIS IS MANDATORY.  One of our coordinators will contact you via email and/or phone to schedule an appointment.  If you do not show up for your scheduled time, you will be removed from our list.   *
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