HiSET and Pre-Employment Skills Training - Worcester Community Action Council

High School Equivalency Test (HiSET) Application

Today's Date

First Name

Middle Name

Last Name

Home/Mobile Phone

Emergency Phone

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Date of Birth

Junior High (Middle) School Attended

High School Attended

City of High School

Grade Last Completed

Date of Last Day

Parent or Legal Guardian's Name

First Name

Last Name

Are you the Head of Household?

Yes

Do you have a job?

Yes

Is there anything that will prevent you from going to class everyday?

Yes

If yes, please explain

Tell us something about yourself

Although we can not promise to give you your choice, we would like to know if you prefer morning or afternoon classes.

Morning

Afternoon

For More Information Contact

Mel Hidalgo, HiSET Instructor
(508) 754-1176 x181

Imalay Holguin-Guzman, JEC Career Navigator
(508) 754-1176 x215

High School Equivalency Test Application