For the Nations DC English Classes, Fairfax Student Registration Form - Fall 2024
This form is for students who want to study English at our Fairfax location. Our Fairfax location is at:

Redeeming Grace Church, 5200 Ox Rd, Fairfax, VA 22030

The classes are Monday, Wednesday, and Friday from 9:30 am to 11:30 am. To study English with us, you must come to class all three days.
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Student's First Name *
Student's Last Name *
Student's Gender *
If you are completing this form for a friend or family member, please enter you name and phone number here. 
Student's Cell Phone Number. (If you are filling out this form for the student, please list the student's phone number here. If the student does not have a phone number put "none.") *
Student's WhatsApp Number. If you don't have a WhatsApp number, put "none." (If you are filling out this form for the student, please list the student's  WhatsApp number here. We use Whatsapp to send pictures and homework for class.)
 *
Students' Email Address. If you don't have an email address, put "none."(If you are filling out this form for the student, please list the student's email here. We use email to set up an account for doing homework.)
Street Address (Ex. 123 Main Street Apt. 104) *
City *
State *
Zip Code *
Which is true for you? Select "NEW" if this is your first time studying English with us. Select "RETURNING" if this is NOT your first time studying English with us.  *
Will you bring children (0 -5) with you to class? *
If you are bringing children, please list the names and ages of the children you will bring. You must also complete a child registration form for each child you will bring.
Which is the main way you will come to English class? *
Which country are you from? *
What is your first language? *
How well can you READ in your first language? *
Very Little (*)
A lot (*****)
How well can you WRITE in your first language? *
Very Little (*)
A lot (*****)
What other languages do you speak?
How long have you been living in the United States? *
What is the highest level of education you have completed? *
Do you have a job now? *
How did you find our English classes? *
Can we use your photo and/or your children’s photo for our website or materials like fliers? *
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