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Citizenship Preparation Pre-Registration Form

Fall 2023 Citizenship Preparation Pre-Registration Form

Please fill out this form completely. Please note that this form is only for Citizenship Preparation class registration. 

Once you complete the form, you will be contacted by a member of our office staff to confirm your testing and orientation appointment within 48 hours. Thank you.   

Student Information

Have you previously enrolled for ESL classes at RACE?*
Answer Required
Gender*
Answer Required
We would like to stay in communication. Do you accept to receive text messages from us (xxx-xxx-9001)? (Data rates may apply. This number only delivers messages.)*
Answer Required
Race*
Answer Required
What is your Ethnicity?*
Answer Required
What is your employment status?*
Answer Required
Do you have children receiving Free/Reduced Lunch? *
Answer Required
Are you receiving CalWorks (Medi-Cal/Medicare, CalFresh, EBT, WIC, any government assistance)?*
Answer Required

Education

What is the LAST grade you completed? (select one)*
Answer Required
Highest Education Level*
Answer Required
Was the majority of your schooling outside the U.S.?*
Answer Required
Do you have a high school diploma?*
Answer Required

Communication Preferences

What is your preferred method of communication? *
Answer Required
How did you hear about us?*
Answer Required

Emergency Contact

Goals

Primary Goal*
Answer Required
Secondary Goal*
Answer Required

Orientation and Class Preference

Preferred Orientation Time*
Answer Required
Preferred Class Location *
Answer Required

Student Expectations

By checking this box, you acknowledge that you will attend on time. All classes are subject to availability. *
Answer Required
Regular Attendance is Required*
Answer Required
Confirmation Email