Technical College System of Georgia
Office of Adult Education
FY17 Intake Assessment Form
Participant Worksheet
Please indicate whether the following statements are true or false.
______/ 1. The Intake Assessment Form is the foundation of data collection for federal and state reporting.______/ 2. The items on the IAF marked with an asterisk are optional.
______/ 3. Students’ pre-test score(s) should be entered in the box on page one.
______/ 4. Students should be encouraged to provide their Social Security Number as it will help our program meet our performance goals.
______/ 5. If a student does not identify an ethnicity, race, or gender, the local program can complete those categories for the student.
______/ 6. Students who are dual enrolled can indicate that status under the Special Enrollment section. They can also enter their Banner ID number.
______/ 7. There are two employment statuses: employed and unemployed.
______/ 8. For the Special Status Populations questions, students are required to mark either “Yes” or “No” for each item.
______/ 9. Students should select the goals that reflect what they want to achieve by enrolling in the adult education program.
______/ 10. The interviewer conferences with the student and completes the four interview questions.
Finish this tutorial by completing an online evaluation form located at https://www.surveymonkey.com/r/FY17Intake.