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ACCC English Class Registration Form
Sign up for Classes at the Asian Community & Cultural Center. Call
(402) 477-3446
for help registering.
Gọi (402) 477-3446 để được trợ giúp đăng ký.
请致电 (402) 477-3446 寻求注册帮助。
اتصل بالرقم (402) 477-3446 للمساعدة في التسجيل.
د راجستر کولو مرستې لپاره (402) 477-3446 ته زنګ ووهئ.
စာရင်းပေးသွင်းရာတွင် အကူအညီရယူရန် (402) 477-3446 သို့ခေါ်ဆိုပါ။
Телефонуйте (402) 477-3446, щоб отримати допомогу з реєстрації.
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* Indicates required question
Name
*
Your answer
Phone Number
*
Your answer
Which class do you want to join?
*
English Class - Fridays at ACCC 10:30am-12pm (Beginning Level)
English for Driving Class - Wednesdays at ACCC 4pm - 6pm July 29th - August 19th
Email Address
Your answer
Do you have a learner's permit? (for Driving Classes)
Yes
No
I don't know / I can't get one right now
Clear selection
Do you need a ride to class?
*
Yes
No
Maybe
Date of Birth
*
MM
/
DD
/
YYYY
Home Address
*
Your answer
Native Language
*
Your answer
Home Country
*
Your answer
Do you receive any government benefits?
*
SNAP EBT
TANF or ADC
Other Benefits
I don't receive any benefits
I don't know
Required
Any questions about the class?
Your answer
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