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Group Membership Form

Section 1 Program Information:

Section 2 Type of program:

Adult School

Faith-based

College

Community-based (CBO)

Library

Other

For other:

Section 3 Services your program provides (Please check all that apply):

Basic Literacy

ESL

GED

Family Literacy

Workplace Literacy

Math

Citizenship Classes

Job/Career Improvement

Computer Instruction

Other

For other:

All information will be confidential and will not be distribute or sold.

Please feel free to contact us with any questions.

Phone (323) 319-6151 or office@unitedliteracy.org