Sign Up Here for English Language Classes
English Class Registration Last Name * First Name * I am a returning student * Yes No Email Address * Home Address * City * State * Zip * Home Phone Cell Phone Emergency Contact Name * Emergency Contact Phone Number * Country of Origin * Native Language * Birthday (ex. 0/00/0000) * Spouse's Name Please List Children's Names and ages I will be using the Nursery * Yes No My Highest Level of Education is (for example high school, undergraduate, graduate) My Career/Field of study is (major study in college of job) I have studied English ___ years (type number of years) I have an English Tutor * Yes No I wish to study English because (example: I want to be able to talk on the phone to make Dr. appointments) How did you hear about our program? (internet, friend, etc) Office Use This section is for office use only Please do not fill out. Thank-You Class Attending Tuesday Wednesday Thursday Class Level Basic Beginner Intermediate Advanced Conversation Payment Receipt Number
Last Name *
First Name *
I am a returning student * Yes No
Email Address *
Home Address *
City *
State *
Zip *
Home Phone
Cell Phone
Emergency Contact Name *
Emergency Contact Phone Number *
Country of Origin *
Native Language *
Birthday (ex. 0/00/0000) *
Spouse's Name
Please List Children's Names and ages
I will be using the Nursery * Yes No
My Highest Level of Education is (for example high school, undergraduate, graduate)
My Career/Field of study is (major study in college of job)
I have studied English ___ years (type number of years)
I have an English Tutor * Yes No
I wish to study English because (example: I want to be able to talk on the phone to make Dr. appointments)
How did you hear about our program? (internet, friend, etc)
This section is for office use only
Please do not fill out. Thank-You
Class Attending Tuesday Wednesday Thursday
Class Level Basic Beginner Intermediate Advanced Conversation
Payment Receipt Number
Before winter break, one of our English as a New Language classes was ...
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Sign up here for English Language Classes.
A listing of upcoming event for our International and English Class friends!
Takes place the 1st Saturday of every month at 7 p.m. in the Haase Prayer ...
4850 E Main Street
Carmel, IN 46033
317.814.4252
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