ELL student form
Para la versión en español de este formulario, haga clic aquí. This program and all associated curriculum are FREE for those who desire weekly tutoring in English. Thank you for your interest in learning English. Please answer the following questions as best you can! Paper application forms are available at Crossroads and the Pella Library.
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Email *
Name *
Phone *
May we text you? *
What country are you originally from? (Not required)
What is your native language? *
What level of schooling have you completed? *
How would you describe your level of English? *
Are you familiar with the English alphabet? (as opposed to a character based language?) *
Please indicate what times you are available for a one-hour lesson
8:00 am-12:00
12:00-5:00 pm
5:00-8:00 pm
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Because this program is free, I understand that I will be expected to meet with a tutor at least 3 times per month, and that missing more than one session per month may result in my tutor being assigned to another student. Typing my name below indicates my commitment to this program and my understanding of the expectations. *
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