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Paraeducator Certification Program Interest Form
Please complete this form if you would like information on Lompoc Adult School's Paraeducator Certification Program. Someone will contact you shortly after you submit your completed form.
Do you have a High School Diploma or Equivalency such as a GED?
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Please Select…
Yes
No
Are you 18 or older?
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Please Select…
Yes
No
Please check the following true items:*
I am interested in working with bilingual students
I am interested in working with special needs students
I am interested in working with general education students
How did you learn about this program? Check all that apply:*
Flyer
LASCC Staff
Facebook
I am a LASCC student
Other
First Name
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Middle Name
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Last Name
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Phone
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Email Address
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Birthdate
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(mm/dd/yyyy)
Please enter any questions that you may have
Please send a confirmation email to the address below: