EmailMeForm
Pre-Registration Form
Adult Education & Literacy/St. Charles Community College
Thank you for your interest in our Adult Education & Literacy program! Because we are a grant-funded program, almost all classes offered are FREE.
Due to the Covid-19 pandemic, most instruction will be offered remotely. Completion of the Pre-Registration form does not guarantee placement in a class. All students MUST be assessed prior to beginning class. This form must be completed and submitted prior to the scheduling of your assessment. We will contact you by EMAIL after receipt of your pre-registration form to let you know your next steps.
Requirements:
Must be at least 17 years of age
Cannot be enrolled in high school
Cannot hold an F1 (Student) Visa
Name
*
First
MI
Last
Email
*
Ex: yourname@email.com
Confirm Email
Date of Birth (You must be at least 17.)
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Phone (Preferred Contact)
*
###
-
###
-
####
Phone (Alternate Contact)
*
###
-
###
-
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Registration/Class Sessions: Morning (AM) or Evening (PM)
*
I want AM Registration/Class sessions.
I want PM Registration/Class sessions.
Is English your first language?
*
Yes
No
Non-native English speakers must take an English placement test before entering high school equivalency or specialty classes.
I would like to enroll in:
*
The English as a Second Language Program to learn English or improve my English skills for college or career readiness.
The Adult Basic Education Program to get my high school equivalency, improve basic academic skills and/or prepare for college readiness or career advancement.
Select the classes in the English as a Second Language program that you're interested in:
Select All that Apply
ESL (English as a Second Language) classes
Advanced Writing
TOEFL Preparation
Pronunciation
Citizenship
Certified Nursing Assistant
Certified Kitchen Cook
Certified Logistics Assistant
Certified Logistics Technician
Microsoft Office Specialist
Select the classes in the Adult Basic Education program that you're interested in:
Select All that Apply
High School Equivalency Preparation Classes
Classes to improve basic academic skills for college readiness or career advancement
Focus Forward Developmental Math Classes
Certified Nursing Assistant
Certified Kitchen Cook
Certified Logistics Assistant
Certified Logistics Technician
Microsoft Office Specialist
Do you have an F-1 Visa?
*
Yes
No
Students with an F-1 Visa are not eligible to enroll in our program.
Are you enrolled in high school?
*
Yes
No
Students currently enrolled in high school are not eligible to enroll in our program.
Have you attended classes in our program previously?
*
Yes
No
When did you attend our program previously?
Please select
Currently attending
Last year
2 years ago
3 or more years ago
Do you have reliable, high-speed internet access?
*
Yes
No
Students must have access to high-speed internet to be able to complete the assessment testing required prior to class attendance. Please email smugler@stchas.edu or call 636-922-8411 if you have questions.
Can you access one of the following devices with internet, a webcam & microphone for 2 separate testing sessions totaling about 5 hours? (This will be necessary for the enrollment process and cannot be done in a public space.)
Desktop computer
Laptop computer
None of the above
This technology will be required to complete the assessment testing required prior to class attendance. Please email smugler@stchas.edu or call 636-922-8411 if you have questions.
IF you could choose, would you prefer to take your registration assessments in person at St. Charles Community College (wearing a mask and social distancing) or on a destop/laptop computer by Zoom?
In person face-to-face registration
Remote registration by Zoom
For CLASS attendance after enrollment, you can use any of the following devices. Which do you have available to you? (Do not select if the device does not have a working camera, microphone and speaker.)
*
Desktop
Laptop
MAC
Chromebook
Tablet
Smartphone
None of the above
This technology will be required for online class attendance. Please email smugler@stchas.edu or call 636-922-8411 if you have questions.
How familiar are you with using your device?
*
 
Worst
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2
3
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5
 
Best
How familiar are you with cut, copy & paste?
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Worst
1
2
3
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Best
Will you be able to attend your class online each time it is scheduled?
*
Yes
No
Will you be able to complete online work assigned by your classroom teacher?
*
Yes
No
Have you ever used Zoom?
*
Yes
No
Questions / Comments