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Literary Council Student Application

Personal Information
Gender: Male Female
Marital Status:
Single
Married
Widowed
Ethnic Group:
Caucasian
African-American
Hispanic
Native American
Asian
Other
Education Level:
8th
9th
10th
11th
12th
High School Diploma
Other
What is your goal?
GED
Reading/Math
Computer Use
Driver's License
Have you been tested at South Ark? Yes No
Do you have test scores? Yes No

Are you... (Check all that apply)

Employed
Unemployed
Not in labor market
Disabled
Assisted Living
Current Military
Veteran
Emergency Contact Information
Please indicate a person to contact if there is an emergency on a volunteer site.
By checking the box, I certify that the above information is true and correct.
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