Registration for English Classes from Al-Bustan

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Rooted in Arab arts and language, Al-Bustan Seeds of Culture offers arts and education programming that enriches cross-cultural understanding and celebrates diversity.

“Al-Bustan,” Arabic for “The Garden,” serves youth and adults of all ethnic, religious, and socio-economic backgrounds, while supporting the pursuit and affirmation of Arab American cultural identity and playing a constructive civic role within broader American society.

Note: This cycle of English classes is intended to run from mid-September to the mid-November.

Please contact Al-Bustan Programs Coordinator Bridget Peak at bridget@albustanseeds.org with any questions.

Contact Information

Please provide your contact information below. We will not share your information outside of Al-Bustan Seeds of Culture.

Name: *

Email Address: *

Phone Number: *

Zip Code: *

Demographic Information

Are you of Arab-heritage? Note: This cycle of English Language Classes are intended for native Arabic speakers. *

Yes

I choose not to disclose this information

In addition to being Arab, do you identify as any of the following? *

Asian or Pacific Islander

Black or African American

Hispanic or Latino

Native American or Alaskan Native

White or Caucasian

Multiracial or Biracial

Other

I choose not to disclose this information

Which income range most accurately represents your annual household income? *

less than $19,999

$20,000 to $39,999

$40,000 to $59,999

$60,000 to $79,999

$80,000 to $99,999

$100,000 or more

I choose not to disclose this information

Gender: How do you identify? *

Woman

Man

Nonbinary

I prefer to self describe (please self-describe below)

I choose not to disclose this information

Other:

What year did you arrive in the United States?

How many children are in your family and what are their ages?

How can Al-Bustan help your family?

English Proficiency

What do you think is your speaking and aural comprehension level in English? *

None

Beginner

Intermediate

Advanced

What do you think is your writing comprehension level in English? *

None

Beginner

Intermediate

Advanced

What do you think is your reading comprehension level in English? *

None

Beginner

Intermediate

Advanced

Questions or comments on what you hope you will gain from English classes:

If you would like to discuss this program in more detail, please contact Al-Bustan's Programs Coordinator Bridget Peak, at bridget@albustanseeds.org.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms