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 Adults With Disabilities Program 
 Community Service Classes 
 Computer Classes 
 English as a Second Language Program 
 Health Programs 
 High School Diploma Program and GED 
 Languages 
 Older Adults Program 
 Parenting Classes 
 Traffic Violator School 
 
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Sex  Male  Female

Ethnicity 
Hispanic or Latino Not Hispanic or Latino

Race (mark all that apply)
White
Asian
Black or African American 
Native Hawaiian or other Pacific Islander 
Filipino
American Indian
Alaska Native

Number of years of school completed 

Degree Earned 
None
GED Certificate
High School Diploma 
Technical/Certificate 
AA/AS
4 yr. College Graduate
Graduate Studies
Other

Native Language 
English
Spanish
Vietnamese 
Chinese 
Hmong 
Cambodian 
Tagalog
Korean 
Lao
Russian 
Farsi
Other 

Reason For Enrollment 
  Primary     Secondary    
Improve basic Skills
Improve English skills
HS Diploma/GED
Get a job
Retain job
Enter college or training
Work-based project
Family goal
US Citizenship
Military
Personal goal
None
Other

Personal Status (mark all that apply)
TANF
Other Public Assistance
WIA 1B 
Rehabilitation 
Concurrently enrolled in high school/K-12 
Dislocated Worker
Veteran
Disabled 
Displaced Homemaker
Single Parent 
Bogg Grant
Pell Grant 
GA (Gen Assist.)
SSI 
Bur. Indian Aff. 
Other 

Labor Force Status 
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