(ESL) English as a Second Language Program for Adults (Fall 2019)
Assalam Alaikum!

Many of us aspire to learn English in order to communicate with others and teach them Islam. Alhamdulillah, now it is possible! We are excited to be launching our Adult ESL program for ages 18 and up.

Please contact imamsekta@isak.org for any questions or concerns.

Jazakum Allah Khaira!

Information about the Program
Section 1: Personal Information
First and Last Name *
Your answer
Age *
Your answer
WhatsApp Phone Number for weekly announcements *
Your answer
Email Address *
Your answer
Mailing Address *
Your answer
What level of education have you completed? *
What is your exposure to English? *
Have you previously attended the English program at Ibn Aljazari Institute? *
If YES, which level have you previously completed? *
What is your first language? *
Your answer
Section 2: Emergency Medical Authorization
Please, list your medical history including allergies and medications need to be taken during school time. Please, write NONE if there is not any. *
Your answer
Section 3: Tuition Fees
Are you an ISAK member? *
Please, indicate below if you need any financial assistance: *
If you choose FULL or PATIAL assistance, please send any of the following documents to imamsekta@isak.org or bring them to the front office. (Proof of Income, Income Tax, Two latest Paystubs, Other documents that support your case)
Your answer
Section 4: Media Consent
Do you give us the consent to take some pictures of you during program activities for the purpose of promoting education? *
Section 5: Student Sponsorship
Would you like to sponsor students? *
If YES, please provide us with the number of students you would like to sponsor.
Your answer
If there is a specific student(s) you would like to sponsor, please state his/her name below.
Your answer
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This form was created inside of Islamic Society Of Akron and Kent.