Community Action, Inc. Adult Education Program
Student Registration Form Instructions

8/08

A student registration form must be completed for each student every Community Action, Inc. Adult Education Fiscal Year (July 1 - June 30).

It is usually best to assist students in the completion of the registration form. The top half (demographic information & signatures) of the form is for students. The bottom half is to be completed by Adult Education staff.

The Goals form can be used to collect the information asked for in the Profile Variables and Participants Goals sections; Information can then be transferred to the Registration form. Baseline assessment scores are documented in the last section of the registration form.

Important Notes:

Date of First Contact
The date the student attended a new student orientation or registered for the current program year.

Social Security Numbers & Document Information
Students who do not have a social security number may attend classes. If a student does not have a social security number, please leave the SS and documentation section blank. It will be completed at the main office.

D.O.B. = Date of Birth
Always check the student's date of birth. This is a common place for mistakes.

Check each registration form closely before filing and sending a copy to the main office.

Completed registration forms are routed to the main office (Terri Schiemenz) or the designated data entry person on a monthly basis (by the 10th of each month.) Keep a copy for the student portolio (file).

*Download registration forms here.

*Check the website prior to registrations/orientations to make sure that you have the most up to date Registration and Progress Forms.