Student Profile - SWTC Continuing Education

E-mail*

You will use your email address as your username on this site.

Re-enter E-mail*

Password*

Password: minimum 12 characters, must contain a number and any two of the following three: upper case, lower case, special characters (for example: (){}!@$%^&*)

Strength

Re-enter password*

Password hint*

Identity Verification Question*

Identity Verification Answer*

First name*

Middle Name

Last name*

Preferred First Name

First name you choose to use other than your legal first name.

Suffix

Gender*

Female
Male
Not Specified

Birthdate*

Senior*

Yes No
Are you 62 years of age or older?

Social Security Number

Please provide your Social Security Number to ensure accuracy in your student record.

Phone*

Additional phone

Primary Address

Primary Address Type*

Permanent

Country*

line 1 > Address*

line 2 > Address

City*

State*

Province *

Zip*

Zip+4

Secondary Address

Same as Primary Address

Secondary Address Type

Country

line 1 > Address

line 2 > Address

City

State

Province

Zip

Zip+4

Mail preference

May we include you on our mailing lists?

Yes No

E-mail Preference

Yes No
Receive course related info via e-mail?

Ethnic Groups*

Select one or more ethnic group.

Hispanic/Latino*

Hispanic Origin

Only need to complete if Hispanic was selected on prior question.

Marital Status

Veteran*

Are you a US Veteran, current member of active-duty Armed Services, National Guard or Reserve?

Most Recent High School Education*

Select the recent high school attended, home school, GED, HSED, international, or unknown.

Do you have a High School Diploma?*

High School Graduation Date

Provide your high school graduation date in the following format mm/dd/yyyy

GED or HSED Status at Enrollment*

Do you have a GED or HSED at time of enrollment?

GED or HSED Date

Enter the date you received your GED or HSED. Leave blank if no GED or HSED.

Cancel

County of Residence*

County and Municipality*

Select on your permanent home residence. Choose Out-of-State if not in Wisconsin.

Grade Level*

Highest Grade Completed

Company

If your company is not available in the list, select ** Add Company ** and you will be prompted to add your company's information after submitting this form.

Class unlock keys

Enter multiple separated by comma.

Cancel

Student's Highest Grade Completed at Enrollment*

What is the highest grade you have completed?

Student's Highest Credential Completed*

Select highest credential/degree you have completed. If in high school select, No Credential.

Person with Disability*

Indicate if you are not disabled or have a disability without specifying the primary disability.

Economically Disadvantaged*

Any individual or member of a family who is unable to pay for one or more basic living needs.

Foster Care Youth*

Were you in foster care between the ages of 16 and 24?

Single Parent*

You are unmarried or legally separated and have custody of 1 or more minor children, OR are pregnant

Displaced Homemaker*

Has been dependent on the income of another family member but is no longer supported by that income.

Homeless Individual*

An individual who lacks a fixed, regular, and adequate nighttime residence.

Work Status at Enrollment*

Client's employment status at enrollment. Employed means working for compensation.

Limited English Proficiency*

Limited ability in speaking, reading, writing or understanding the English language.

Highest Degree Earned by Either Parent*

What is the highest degree earned by either of your parents?

Youth with Parent in Armed Forces*

Have either of your parents served in the Armed Forces on Active Duty?

Cancel

CONTACT INFORMATION
Phone: 608.822.3262
Toll Free: 800.362.3322

TDD (hearing impaired): 608.822.2072
FAX: 608.822.6019

HOURS
Monday-Friday 7:30am to 4:30pm
Closed Fridays during June & July

SOUTHWEST TECH
1800 Bronson Boulevard
Fennimore, WI 53809
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