Course Selection

Course Time / Modality Categories*
Please choose one
Morning Course Schedule*
Evening Course Schedule*
Online Course Schedule*

Student Information

Name*

Age Guidelines

GED classes available for those 17 years or older, who have not completed high school and preparing to take the Texas Certificate of High School (TXCHSE) test, formally known as the GED test.

Students, age 17 or 18, must have a parent or guardian’s consent to participate.

Students, age 16, may participate, but a court order and a parent or guardian’s consent are required.

Date of Birth*
What is your current age?*
Gender*
Address*
Will you be taking classes in Midland or Fort Stockton?*
Format: (432) 685-0000
Is it okay if we send text messages to this number?*
Ethnicity*
Race - Check at least one and all that apply*

Equal Opportunity Information

Do you have a disability?*
Category of Disability (check all that apply)*

Veteran Characteristics

Are you a Veteran or Veteran Dependent?*
Eligible Veteran Status*
Are you a disabled veteran?*
Date of Actual Military Separation*

Employment and Education Information

Employment Status*
Yes, Unemployed 27+ Consecutive Weeks*
whole numbers only
Reason for not looking for work*
Date of release from incarceration*
What type of community do you live in?*
Does your household include a child younger than 19 years of age?*
Are you currently receiving the following?*
Are you a noncustodial parent paying child support for children younger than 19 years of age?*
What is your current school status?*
Origin of Education Completion*

Migrant and Seasonal Farmworker Characteristics

Migrant and Seasonal Farm Worker Status*

Public Assistance Information

Are you currently on Public Assistance?*
Are you on Expanded Eligibility for TANF?*
TANF Exhausting in two years?*

Additional Reportable Characteristics

Check Yes or No for the following scenarios:*
Check Yes or No for the following scenarios:
  Yes No
Foster Care Youth
Homeless/Runaway
Low Income
English Language Learner
Cultural Barriers
Immigrant
Displaced Homemaker
Single Parent (including single pregnant women)
Displaced Worker
Parent of children ages 0-5
Parent of children ages 6-10
Parent of children ages 11-13
Parent of children ages 14-18
Ex-Offender

One-Stop Program Participation

WIOA = Workforce Innovation and Opportunity Act and assists job seekers with accessing employment, education, training, and support services they need to meet employers’ requirements and succeed in the labor market.

Check Yes for the following scenario*
Check Yes for the following scenario
  Yes
Adult Education
Check Yes or No for the following scenarios: *
Check Yes or No for the following scenarios:
  Yes No
WIOA Adult
WIOA Dislocated Worker
WIOA Youth
Job Corps
Vocational Rehabilitation
Wagner-Peyser Employment Service

Corrections and Institutional Funded Program Participants

Check Yes or No for the following scenarios:*
Check Yes or No for the following scenarios:
  Yes No
In Correctional Facility
In Community Corrections
In Other Institutionalized Setting
On Parole
On Probation (community supervision)

Special Program Type

Check Yes or No for the following scenarios:*
Check Yes or No for the following scenarios:
  Yes No
Family Literacy Program
In Workplace Literacy Program
Participant in Job Training Program
One-Stop Center Referral
TANF Referral
College Referral

Consent Section

Participant Release of Information and Permission to Participate in the Program

The information provided is complete and correct to the best of my knowledge. I agree to abide by the Adult Education Program policies, rules, and regulations. I further understand the submission of false information is grounds for rejection on my application, withdrawal of acceptance to the Adult Education Program, and cancellation of enrollment. Participants who are 16 years of age must have a court order. By signing this form, parents of 17- and 18-year-old students give permission for their student to participate in this program. By signing this form, the student and the parent acknowledge that they give consent to release personal identifiable information, which may consist of directory information (name, address, and telephone number), date of birth, dates of attendance, degrees and certificates obtained, and field of study to Texas Workforce Commission, the Texas Higher Education Coordinating Board, and Texas Education Agency. Failure to provide consent to share the above referenced information will result in the removal of the student from Adult Basic Education services.

Student Consent - Participant Release of Information and Permission to Participate in the Program*
Consent must be given in order to enroll in the GED program
Parent/Guardian Consent - Participant Release of Information and Permission to Participate in the Program*
Consent must be given in order to enroll in the GED program

Post Secondary Enrollment Participant Release of Information

I hereby give my consent to release personal identifiable information regarding my enrollment in post-secondary institutions as matched to the Texas Higher Education Coordinating Board (THECB) master enrollment records for the sole purpose of statistical analysis and adult education program improvement. Information will be released and exchanged between the Texas Education Agency (TEA) and THECB. Students who are 16, 17, or 18 years of age must have parent or guardian permission to participate in the program.

Student Consent - Participant Post Enrollment Participant Release of Information*
Consent must be given in order to enroll in the GED program
Parent/Guardian Consent - Post Secondary Enrollment Participant Release of Infromation*
Consent must be given in order to enroll in the GED program

Employment Participant Release of Information

I hereby give my consent to the Texas Workforce Commission to release personally identifiable information regarding my employment status or history to the THECB and or TEA for the sole purpose of statistical analysis, administration, or evaluation for the improvement of state adult education programs.

Student Consent - Employment Participant Release of Information*
Parent/Guardian Consent - Employment Participant Release of Information*
Use your mouse or finger to draw your signature above
Parent Name*
Use your mouse or finger to draw your signature above

Student Contract

Adult Education Literacy Student Contract


Midland College Adult Education & Literacy (AEL) program is based on students becoming responsible for achieving their own educational goals. We believe that everyone can be successful and learn given enough time and desire. How far and fast you progress ultimately depends on you! Learning is a joint task.

Our staff will provide you with timely instruction, materials, and computer-assisted instruction. We are here to assist you in finding your learning strengths, to be friendly, professional, courteous, and supportive. We will encourage you to be the best you can be and help you identify and achieve your short and long term goals.

DRESS CODE

All students are expected to dress appropriately for class. Students should not wear clothing that is tight, revealing, torn, or displaying language that is vulgar or otherwise inappropriate. Undergarments should never be visible. Students who fail to comply with the dress code will be referred to the site supervisor and will not be permitted to return to class until they are dressed appropriately.

CLASS BEHAVIOR

Students are expected to conduct themselves in a responsible, adult manner and to be respectful of their teacher and fellow students. Vulgar or inappropriate language will not be tolerated. All electronic devices should be put away and be turned off. Cell phones should be set to “silent” or “vibrate.” Text messages and telephone calls should only be made or accepted during break or after class. Texting during instructional time is prohibited. Children are not allowed in classrooms or on the premises while classes are in session.

INTERNET USAGE

Internet usage is provided solely for accessing educational programs. If a student is using entertainment, communication, social, or “inappropriate” web sites, the teacher has the right to ask the student to leave class. Students should never download any application to a classroom computer. In addition, students need to note they have no privacy rights concerning information stored on, and transmitted via institutional computer equipment, this includes any e-mail or instant message.

ATTENDANCE

Students are expected to attend at least 80% of all classes that are scheduled and must attend at least 40 hours. Students are expected to notify the teacher if they have to miss a class or drop out of the program. At the end of each month, attendance is reviewed and any student who has missed 5 or more times will be put on probation. Once on probation, any student who fails to meet the attendance requirement may be dropped.

ASSESSMENTS

All students must take a baseline test and a progress test. Students are expected to make a sincere best effort on all tests. Students must take an exit examination (progress test) should they leave the program for any reason before completing the GED® testing process. Students who leave without testing will not be eligible to re-enter class or re-enroll in classes at a later date.

DRUGS, ALCOHOL, AND FIREARMS

Illicit drugs and alcohol are explicitly prohibited. Any student in possession, or under the influence, of drugs, alcohol, and/or possessing firearms without a valid license will be immediately terminated from the program. If this occurs, police will be notified and charges will be filed against the perpetrators. The handgun must be concealed at all times. No open carry on college campuses.

An individual may not bring a handgun into an exclusion zone. Exclusion zones are clearly marked with signs.

FOOD AND DRINK

Our goal is to keep our learning environment clean. To protect our equipment, food and drink are not allowed in the classroom, except for holidays, or with prior permission from the director. Everyone is responsible for cleaning up their area and putting trash in the garbage can.

 

I have read the Policies and Procedures above and if I am accepted into the Midland College Adult Education Literacy program, I hereby agree to abide by these requirements.

Use your mouse or finger to draw your signature above

Student Training, Education and Career Plan

What is your long-term goal? (Check all that apply)*
Check three small goals that will help you reach your LONG-TERM goal*
What skills or education will you need to accomplish your career or your job? (Check all that apply)*
What obstacles might keep you from completing your goals? (Check all that apply)*
What do you need help with in order for you to be successful in our program? (Check all that apply)*
What resources do you need to help you complete your goal(s)? (Check all that apply)*