Adult Education Registration
First Name
Last Name
Phone
Email
Street Address
City
State/Province
Postal Code
Country of Origin
When did you come to the US?
Date of Birth
Did you study English before?
Yes
No
Do you have access to a computer, phone or tablet with reliable internet?
Yes
No
Have you used Zoom or another video conferencing program before?
Yes
No
Are you interested in morning (10am-12pm) or evening (6-8pm) classes?
Morning (10am-12pm)
Evening (6-8pm)
I cannot attend class during these times
Contact Information