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Vacaville Adult School
Community Education   Computer Classes   Vocational Education	Fields with a "*" are required.   Student First Name  * Student Last Name  * Address  * City  * State  * ZIP  *   Home Phone  * Work Phone    Email  * Confirm Email  *   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  0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 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 * Employed Unemployed Not employed and not seeking work   Retired  Create your own User ID and Password.  Note them for future use. (User ID & Password are case sensitive.)   User ID  Password  Re-confirm Password