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First Name
Last Name
E-mail Address
Birthdate
Address
Apartment #
City
State
Zipcode
Telephone
Number of People In Household
Type of Applicant
Current Youth Program Participant
In-School
Out-of-School
Non-Program Students
Adults Ages 25 and Over
Non-Profit Company
For-Profit Company
Household Annual Income
$0 – $12,880
$12,880 – $17,420
$17,420 - $21,960
$21,960 - $26,500
$26,500 - $31,040
$31,040 - $35,580
$35,580 - $40,120
$40,120 - $44,660
$44,600 and Over
Ethnicity
African American
Hispanic/Latino
Caucasian
Asian
Native American
Other
Gender
Male
Female
GED Essentials Academy
Writing
Reading
Science
Math
Social Studies
TABE
FAFSA Workshop
Higher Education
College Counseling Services
Six Basic Computer Skill Classes
Computer Activity Skills
Common Computer Skills
Getting Started on a Computer
Keyboarding
Navigating Using Menus
The Computer Desktop
Additional Information
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