Technical College System of Georgia s1

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