Order Number Aspire Orientation Registration Form Please fill in the form below. This training is FREE. First Name * Middle Initial * Last Name * Maiden or other former name Address * Full address, including city, state, zip & county Email Address * Phone * Are you over 16 and formerly withdrawn from school? * Yes No General Information Do you have an F-1 Visa? * Yes No Education (including from another country) * Last full grade completed Did you graduate from high school or its equivalent? * Yes No What are your goals for coming to this program? * To improve basic skills To improve English language skills (ESOL) To obtain a job To retain or improve current job To earn high school equivalence or secondary school diploma To enter post secondary education or training To decrease public assistance received To obtain citizenship skills To register to vote or to vote for the first time other (please specify) Have you previously been an Aspire student? * Yes No If YES, how long ago? What is your age?