Passport to Life 2010 Registration
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1. Passport to Life 2010 Registration

Please answer the following questions so you can be registered for the Passport to Life event on August 19, 2010. We will have classes on different subjects, and you will be asked to fill in the classes you would like to attend. There will also be people from different colleges, job training programs, military branches, and community services for you to meet and ask questions about your options and opportunities. We look forward to seeing you there!

Please note: deadline for registration submission is August 12th

1. First Name:

First Name:

2. Last Name:

Last Name:

3. Please select your date of birth:

	Month:	Day:	Year
Date of Birth	Please select your date of birth: Date of Birth Month:	Day:	Year

4. What is your address?

What is your address? Address:
City:
Zip Code:

5. What is your e-mail?

What is your e-mail?

6. What school do you attend?

What school do you attend?

7. What is your current educational status?

What is your current educational status? Working on high school diploma

Working to pass the GED

Completed high school diploma

Passed GED

Enrolled in college

Enrolled in vocational training program

8. The next section will ask you about classes you are interested in taking. Please select one class you would like to take for each of the three class sessions. Enrollment in the class is not guaranteed, but by answering this survey, we will do our best to make sure you are signed up for the class and the time you want.

	1st Class	2nd Class	3rd Class
First Impressions	*The next section will ask you about classes you are interested in taking. Please select one class you would like to take for each of the three class sessions. Enrollment in the class is not guaranteed, but by answering this survey, we will do our best to make sure you are signed up for the class and the time you want. First Impressions 1st Class	First Impressions 2nd Class	First Impressions 3rd Class
Landing and Keeping a Job	Landing and Keeping a Job 1st Class	Landing and Keeping a Job 2nd Class	Landing and Keeping a Job 3rd Class
Pathways to Completing a High School Education	Pathways to Completing a High School Education 1st Class	Pathways to Completing a High School Education 2nd Class	Pathways to Completing a High School Education 3rd Class
Education Beyond High School	Education Beyond High School 1st Class	Education Beyond High School 2nd Class	Education Beyond High School 3rd Class
Power and Benefits of Education	Power and Benefits of Education 1st Class	Power and Benefits of Education 2nd Class	Power and Benefits of Education 3rd Class
Financial Aid for Further Education	Financial Aid for Further Education 1st Class	Financial Aid for Further Education 2nd Class	Financial Aid for Further Education 3rd Class
Overcoming Barriers	Overcoming Barriers 1st Class	Overcoming Barriers 2nd Class	Overcoming Barriers 3rd Class
Conflict Resolution: Moving On	Conflict Resolution: Moving On 1st Class	Conflict Resolution: Moving On 2nd Class	Conflict Resolution: Moving On 3rd Class
Conflict Resolution: Overcoming Challenges	Conflict Resolution: Overcoming Challenges 1st Class	Conflict Resolution: Overcoming Challenges 2nd Class	Conflict Resolution: Overcoming Challenges 3rd Class
Take Control of Your Financial Future	Take Control of Your Financial Future 1st Class	Take Control of Your Financial Future 2nd Class	Take Control of Your Financial Future 3rd Class

9. Thank you for signing up for Passport to Life on August 19, 2010! Is there any other information you need?

Thank you for signing up for Passport to Life on August 19, 2010! Is there any other information you need?

There are a few things to remember for the Passport to Life event:

1. Please plan on being at City College by 8:00 am to sign in.

2. For full credit of the 12 community service hours you must be at the event and participating from 8:00 - 1:30.

3. It is also important that you dress appropriately. You will have the opportunity to meet with people from different college, career, job training programs, military branches, and community service agencies. Present your best!

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