Ohio Options for Adults

Aspire and Adult Diploma Programs

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* Location:

* First Name:

* Last Name:

Middle Initial:

Former Name:

* Street:

Street #2:

* City:

* State:

* ZIP Code:

* Phone:

Alternate Phone:

Email:

* Last 4 digits of your Social Security No.:

* Date of Birth

* Are you a U. S. Citizen?

* Gender:

* Are you Hispanic/Latino?

* Ethnic Background:

* Highest education grade completed?

* Where did you complete your schooling?

* Employment Status

* Have you been convicted of a sexual offense in the past fifteen (15) years?

* Are you required to register as a sexual offender?

* Have you ever been convicted of a sexual related offense or violent crime against a minor?

* Have you taken an Official High School Equivalency Test (GED® or Hi-SET)?

Career/Employment Information

* What is your career interests? Please select one. .

* What is your short-term goals? Please select one..

Prepare for the High School Equivalency Test (GED® or Hi-SET)
Improve reading/writing/social studies/science or math
Get a job or a better job
College or a training program
Improve my English
Other

Please check the checkbox.