Student Registration Form for Lawrence ESL Orientation Begins January 10th Session Begins January 18th

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Please submit enrollment information and a staff member will follow up with you on details about our next session

Materials Fee: $25

Non-Permanent Resident Visas Materials Fee: $100

Email *

Please Select the ESL Session you are most interested in attending *

Morning Session (9:30 AM - 11:30 AM)

Afternoon Session (12:00 PM - 2:00 PM)

Late Afternoon Session (3:15 PM - 5:15 PM)

Evening Session (5:30 PM - 8:30 PM)

Required

First Name *

Middle Name *

Last Name *

Birth Date *

YYYY

Email *

Phone Number *

Address (including town, state & zip code) *

Country of Origin

Native Language(s)

Please tell us if there is anything you would like us to know about your current situation that will allow us to meet your educational needs.

Thank you for filling out this form. After you click "submit" a member of the Adult Learning Center staff will be in contact with as the start date approaches to plan the next steps needed to begin your education journey.

A copy of your responses will be emailed to the address you provided.

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