Online/Virtual – Evening

Take classes from the comfort of your home with Mansfield Adult Education’s Virtual Instruction.

Classes meet Monday and Wednesday from 5:00 PM – 8:00 PM

Registration for Online/Virtual classes must be completed at least one week prior to the Preferred Start Date. Please check your calendar then click yes to select a date. After submitting this form you will receive an email containing more information about completing registration.

• Yes

Preferred Start Date for Online Classes *Select DatePlease complete this form if you would like to be contacted when new dates become available.

Are you 19 years of age or older? YesIf No, Stop Here. Please review the enrollment policy for 16-18 yr old students on the resource page of this website.

Date of Birth *

Please use the 00/00/0000 format

Name *

First

Last

Address *

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Contact Phone Number: *

Can you receive text messages at this phone number?

• Yes
• No

Email *

(e-mail confirmation will be sent after you complete sign up)

How did you find out about our program? I have attended beforeCurrent Student referred meFriendFamily MemberEmployerwww.mansfieldadulteducation.comInternet SearchFacebookBillboard/Radio/TV/Newspaper AdJob and Family Services/OhioMeansJobs CenterMadison/Pioneer/North Central State CollegeOther State or Non-Profit AgencyProbation/Parole/CorrectionsPostcard

Participation in Online/Virtual Classes requires a computer with working webcam. Do you have access to the required technology? *

• Yes
• No

Participation in Online/Virtual Classes requires internet access. Do you currently have internet access with adequate speed? *

• Yes
• No

Submit