Name(Required)
Home Address(Required)
Please list the address of the residence affected by disaster.
MM slash DD slash YYYY
Gender(Required)
Are you able to receive text messages from CCEOK?(Required)
Employment Status(Required)
Which classes would you like to enroll this year? Check all choices.(Required)
Where would you like to take your classes? Check choice(s).(Required)
When are you able to attend classes?(Required)
Race or Ethnicity. Check all that apply.(Required)
What technology do you have access to? Check all that apply.(Required)
Why are you enrolling in classes now?(Required)
What is your goal for taking ESL classes?(Required)
Which of the HiSET tests have you passed?(Required)
When do you hope to graduate?(Required)
Do you have any barriers that may prevent you from attending class? Check all that apply.(Required)
When are you available to come to the Tulsa Campus for the mandatory ESL diagnostic test?
You will not be eligible for enrollment in classes until your diagnostic test is completed. Please select a time that you are available to come in and complete the ESL diagnostics. The test will take approximately 30 minutes to complete.
When are you available to come to MOC for the mandatory ESL diagnostic test?
You will not be eligible for enrollment in classes until your diagnostic test is completed. Please select a time that you are available to come in and complete the ESL diagnostics. The test will take approximately 30 minutes to complete.
When are you available to come to the Tulsa Campus for the mandatory HiSET diagnostic test?
You will not be eligible for enrollment in classes until your diagnostic test is completed. Please select a time that you are available to come in and complete the HiSET diagnostics. There are five subject area tests which will take up to 4 hours to complete.
Photo/Audio/Video Release(Required)
Catholic Charities of Eastern Oklahoma (CCEOK) often uses photographs, videos and/or audio in its printed and online publications, including newsletters, brochures, displays, newspaper articles, social media and websites. As a client/volunteer of CCEOK, your image or sound bite may be taken during various activities and may be selected for use in any of our publications. The image/sound bite will be used only to promote and positively recognize CCEOK programs. Catholic Charities of Eastern Oklahoma retains all rights to the photographs, videos and audio recordings. Therefore, we would like to obtain your consent to use any images taken of you for this purpose. I give my permission for my photo, video or audio files to be used in any Catholic Charities of Eastern Oklahoma publications, and I agree to the above terms and conditions.
This field is for validation purposes and should be left unchanged.
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