Choose Your Class Thank you for your interest in taking classes with Blue River Adult Education. Please answer the following questions, and we will reach out to you to let you know of the next steps to begin with our program. Step 1 of 3 33% Name* First Last Phone*Email* Birthday* MM DD YYYY I am enrolling in the following program:*High School Equivalency DiplomaLearn EnglishCareer Training CertificationAccuplacer PrepPlease choose the location you wish to take classes:*Shelbyville – Blue River Adult EducationIndianapolis – Southeast Community Services CenterEdinburgh – Edinburgh High SchoolPlease choose class type you wish to take classes:*Live In-Person ClassesVirtual ClassesPlease choose class time:*Mornings 9am to 1pm – Mondays and WednesdaysEvenings 5pm to 9pm – Mondays and WednesdaysPlease choose class time:*Mornings 9am to 1pm – Mondays and WednesdaysEvenings 5pm to 9pm – Mondays and WednesdaysPlease choose class time:*Evenings 5pm to 9pm – Mondays and WednesdaysPlease choose Orientation Date:*January 20thFebruary 1stFebruary 17thPlease choose the location you wish to take classes:*Indianapolis – Southeast Community Services CenterVirtual OnlyPlease choose class time:*Afternoons 12:30pm to 3:30pm – Tuesdays and ThursdaysEvenings 5pm to 8pm – Tuesdays and ThursdaysChoose Career Training:*NCCER CORE & OSHA 10 (Construction)Community Health Worker (CHW)Customer Service CertificateQualified Medication Aide (QMA)Certified Nursing Assistant (CNA)Child Development Associates Certificate (CDA)WorkOne Career Training ScholarshipAre you currently working in child care?*YesNoWhat is the name of your employer?* Consent* I agree to the privacy policy.Blue River Career Programs (BRCP) works with the following programs and agencies to help students improve their skills and earn better jobs: • Other state-funded adult education programs • Work One offices, job training programs, or service agencies • Public and private colleges • State executive offices, departments, and agencies including the Indiana Department of Workforce Development (DWD), Division of Adult Education and the Indiana Department of Education • The Court System (Probation Officers, Case Managers, etc.) By submitting this form, I understand and agree to the following: • DWD use of directory information (name, address, birth, and social security number) to match test score records, wage information, and college/training program enrollment records that assist the state to evaluate and improve its programs and to report results to the federal and state government • The sharing of information between the agencies and programs listed above. This information may include my name, enrollment information, education/career goals, test scores, and employment history. The information will be kept strictly confidential and will be used for program administration, research, and evaluation purposes.Thank you for your interest in earning your High School Equivalency Diploma with us. Please submit this form and one of our staff members will be in touch to walk you through the process of getting started in our program. We look forward to meeting you in person!Thank you for your interest in learning English with us. Please submit this form and one of our staff members will be in touch to walk you through the process of getting started in our program. We look forward to meeting you in person!Thank you for your interest in one of our training programs. Please submit this form and one of our staff members will be in touch to walk you through the process of getting started in our program. We look forward to meeting you in person!