2019 - 2020 ESL Student Application FORT LEE PUBLIC LIBRARY ESL DEPARTMENT

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Please Note:
1.This form is for NEW students.
2.Registration is on a first-come, first-served basis. If the program is full, you can choose to be placed on the waiting list. Students on the waiting list will be placed in winter classes through mid-February and/or given the opportunity to register for the next session with returning students.
3.We must receive your application by 1/4/20.
4. The basic materials fee for the program is $20.00. This is due before you start class. Please send no money now.
5.Please remember it is very hard if not impossible to make changes once the schedule is complete. Please tell us if your availability changes. We are sorry, but in most cases we cannot make changes once you have been scheduled. If you need to withdraw from a class, you may be placed on the waiting list for the next session.

Name: *

Phone Number: (It is very important that we have a working email and phone number. If we do not, we will not be able to register you for the program.) *

E-Mail Address *

What is your library card number? (You must be a Fort Lee Library cardholder to register for classes. If you do not have a card, you can ask the circulation desk for more information.) *

Where do you live? *

Fort Lee

Englewood Cliffs

Male

Female

What is your age range? *

65 + years old

55 to 64 years old

45 to 54 years old

35 to 44 years old

25 to 34 years old

18 to 24 years old

What country are you from? *

Please finish the following sentence... My speaking and listening skills in English are (Please be truthful about your skills. You will not be happy in a class that is the wrong level and it is not always easy to make changes.) *

beginner level. (I can say or understand almost nothing in English.)

high beginner level (I know basic words and phrases but cannot have a conversation in English.)

intermediate level. (I can have a basic conversation in English but it is hard and I am not comfortable speaking English.)

high intermediate level. (I can speak English okay but I need people to practice with. Listening is harder than speaking and I question myself a lot.)

advanced level. (I can speak, read, and write in English but I'd like to improve my vocabulary and pronunciation and/or practice with Americans.

Why do you want to learn English? *

for a job

for everyday life

to communicate with my family

Other:

What times are you available to take classes on Mondays?

9:45-11:15

11:30-1:00

1:10-2:40

7-8:30

What times are you available to take classes on Tuesdays?

9:45-11:15

11:30-1:00

1:10-2:40

7-8:30

What times are you available to take classes on Wednesdays?

9:45-11:15

11:30-1

1:10-2:40

7-8:30

What times are you available to take classes on Thursdays?

9:45-11:15

11:30-1

1:10-2:40

7-8:30

What times are you available to take classes on Fridays?

9:45-11:15

11:30-1

1:10-2:40

What times are you available to take classes on Saturdays?

9:45-11:15

Thank you! We will call you for more information. Please remember that we can not put you in a class if you do not answer your phone!

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