ELL Student Registration
Name *
Address *
Phone number *
Email *
Birthdate:
MM
/
DD
/
YYYY
Gender
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Where were born?
How long have you lived in Canada?
In your native country, what is the highest grade you went to?
Are you a:
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What is your goal?
How did you learn to speak English?
What are the best day(s) and time(s) to meet with a teacher? *
Do you have a laptop/computer/smartphone to use for classes?
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Please tell us how you found out about our classes.
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Emergency Contact Name *
Emergency Contact Phone Number *
Email Consent:  I give the library permission to either email me program information or share my email address, as required, with my tutor(s).
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Media Release Form
Acknowledgement *
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