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Jamaica Plain Community Centers

ALP Swag Store

ADULT LEARNING PROGRAM

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Use tab to navigate through the menu items.

Home
Enroll
About
Classrooms
Programs
ALP Calendar
ALP Staff
Contact
Resource Center
More

Use tab to navigate through the menu items.

Student Enrollment Form

To enroll, please complete the information below.

Go to CNA Enrollment Form

First Name

Last Name

Middle Name or Initial

Gender *

Male

Female

I choose not to answer

Make a Selection: *

New Student

Returning Student

HiSET - Spanish

HiSET - English

Hernandez K - 8 Student

Margarita Muniz Academy

Email

Primary Phone

Date of Birth

Secondary Phone

Place of Birth:

Address:

Street

City

State

Zip Code

Emergency Contact

Emerency Contact Name

Emergency Contact Address

Emergency Contact City & State

Emergency Contact Phone #

Emergency Contact Relationship

Do you have a Learning Disability?

If you have a disability, please describe below:

Social Security #

Select an option *

I have provided a social security number

I do not have a social security number

Public Assistance: Choose all that apply.

MassHealth

SNAP (Food Stamps)

SSI

WIC

Other

None

How did you hear about ALP?

Family/friend

Website

Social Media

Poster

INFORMATION

JPCC/ALP

20 South Street

Jamaica Plain, Massachusetts 02130

Information Number: (857) 728-0400

Email: info@jpadulted.org

MBTA Directions

Take the Orange Line to Green Street Station. 20 South Street is a 10 minute walk from the Orange Line at the Green Street stop.

Funding Provided by:

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Request for Information

First name*

Last name*

Email*

Address

Phone*

Additional information

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