Registration for Conversational English Classes for Fall 2017 / Spring 2018
PERSONAL INFORMATION:
Conversational English student status
First Name
Your answer
Last Name (family name)
Your answer
Nickname (the name your friends call you)
Your answer
Birthday
Your answer
Gender
Local street address
Your answer
City
Your answer
Zip Code
Your answer
Home Phone No.
Your answer
Cell Phone No. (do you text?)
Your answer
Home e-mail
Your answer
Work e-mail
Your answer
Nationality (home country)
Your answer
Are you a K-State student?
If yes, what is your department?
Your answer
What degree are you pursuing at K-State
FAMILY INFORMATION
Spouse's First Name
Your answer
Spouse's Last Name (family /given name)
Your answer
Does your spouse work?
If yes, what is your spouse's occupation
Your answer
Is your spouse attending K-State?
If yes, what department & degree?
Your answer
Do you have children?
If you have children please list their names, gender and ages (for example: Mary, female, 6; John, male, 8, etc.)
Your answer
Other Information
How long have you been in the USA?
What is your highest level of education and major?
Your answer
What is your religion?
Your answer
Which English class do you wish to attend?
Are you willing to have your picture used for Conv. English purposes within the church only?
How did you hear about Conversational English
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