Register – Middle Peninsula Regional Adult & Career Education

You may begin the application process by completing the form below, or by completing and submitting the class registration form_2020

If you have any questions about the registration forms, please Contact Us.

Last name

First name

Mailing Address

City

State

Zip

Phone

Race

Sex

Age Range

Physical Handicap for Building?

Learning Disability for Instruction?

If Learning Disability, Please Explain:

Employment at Enrollment

Employer

Last Year Completed

Last year of Attendance

Last School Attended:

GED Goal Date

Instruction Options

County (for classroom)

I have taken the GED Test

I plan to take the GED Test in the next 12 months

National External Diploma learners will be referred to Newport News.

Learner Goals at Enrollment

Right click to select multiple options

Secondary Goals

Right click to select multiple options

Other Secondary Goals