We provide experiential learning for students facing challenges in their high school and young adult lives, equipping
them to rise above the social and educational obstacles they face.

GED/Life Skills Program Intake Form

GED/Life Skills Program Intake Form

First Name:
Last Name:
Street Address:
City:
State:
Zip Code:
Home Phone:
E-Mail Address:
Date of Birth:
Age:
Last grade completed at school:
Can you attend class either 8am-12noon or 1pm-5pm?
If no, would you prefer an evening class? (5:30pm-8:30pm)
How will you get to class each day?
Are you employed?
If yes, how many hours a week?
Are you a Families First participant?
If yes, what is the name of the referring agency?
If you have an Employment Counselor at BRIDGES, what is his or her name?
How did you hear about the BRIDGES GED/Life Skills Program?
Please answer the simple math question below to submit the form.
2 + 2 =