New Student Registration Name * Name First First Last Last Email Phone May we text you? Yes No Address * Address Address Address City City State State Zip/Postal Zip/Postal Birthday * Sex: Male Female Prefer not to answer Your Preference:Your Preference: U.S. Citizen Yes No Race/Ethnicity American Indian/Alaskan Native Asian Black/African American Hispanic or Latino Mixed race Pacific Islander/Hawaiian White OtherOther How did you hear about us? Employment Employment Full-Time Part-Time Retired Disabled Unemployed/Looking for Work Other (not available to work) Occupation When can you come to class? Household Marital Status Married Single Divorced Widowed Household income per month * 2500 Do you receive public assistance? (SNAP, Section 8, EBT, etc) Yes No How many people live in your house? Number of children under 18: Are you a single parent? Yes No If you are human, leave this field blank. Next
