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English for Work Interest Form
Community Action, Inc. of Central Texas is offering three FREE online English Second Language classes for adults living in Texas. If you have any questions, contact Andrea at aschipper@communityaction.com
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* Indicates required question
What is your last name?
*
Your answer
What is your first name?
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Your answer
What is your email address?
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Your answer
What is your phone number?
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Your answer
Do you live in Texas?
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Yes
No
Are you 18 years or older?
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Yes
No
Do you have an electronic device and Internet access?
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Yes
No
Which class(es) are you interested in? Mark all that apply.
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English for Medical (Mondays & Wednesdays, 9-11 am)
English for Business (Tuesdays & Thursdays, 6-8 pm)
English for Educators (Mondays & Wednesdays, 6-8 pm)
Required
Are you currently attending a class with Community Action?
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Yes
No
If you are currently attending a Community Action class, what is your teacher's name?
Your answer
An orientation is required for students that are not currently attending a class with Community Action.
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I understand that someone will contact me to schedule orientation if I am not currently attending a Community Action class.
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