update goal – Mercer Community Education and Training

Name*

First Last

Phone*

Email*

Date of Birth*

Age*

This field is hidden when viewing the form

Country of Birth*

This field is hidden when viewing the form

First Language*

MY GOALS: I would like to:*

Check all that apply.

Improve my basic academic skills.

Earn a US High School Equivalency (HSE) diploma.

Enter employment.

Retain my employment.

Enroll in career-related training.

Enroll in postsecondary education (college/university).

Become a citizen of the US.

Increase my involvement with my child’s education and literacy.

This field is hidden when viewing the form

Student Barriers: Other Factors Affecting Learner's Progress

If there is anything else that you would like us to know about you, please type that here:

Learner Agreement

I agree that the above goals are those I choose to work on at this time. I understand that for successful completion of these goals I will need to attend class every time it is in session, complete my assignments, ask for help when I need it, and make a genuine effort to learn. If changes need to be made in my learning plan, my instructor and I will make a new agreement.

Student Signature*

Please type your full name to serve as your electronic signature. Your electronic signature acknowledges your understanding of and agreement to the above described Learner Agreement.

Today's Date:*

As the instructor, I will do everything possible to help the learner achieve the above goals by providing appropriate instruction and by reviewing the learner's progress at regular intervals. I understand that if changes need to be made in the learning plan, the learner and I will make a new agreement.

This field is hidden when viewing the form

Teacher Signature

This field is hidden when viewing the form

Today's Date:

*2022-23 Student Goals

Learner Agreement