FOCUS ESL Registration Form

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FOCUS ESL Registration Form - Summer Term

PARK STREET CHURCH, Boston, USA

We're looking forward to seeing you this summer! :)

Please fill out this form and submit it by May 31, 2020.
The last section of the form is an English Test to place you in the right class.
You will not need to pay until later.

After registration, you will receive another email from us before June 2. In that email, we will give you information about your class placement, classroom link, textbook information, and how to pay for tuition.

Because of the ongoing COVID19 situation, we will begin this term by having classes online using video chat. If the situation changes, we will let you know.

Summer term classes will begin on June 2, 2020, and end on August 6, 2020.

Email *

Your Family Name (Last Name) *

Your First Name *

Which class would you like to register for? *

Conversational English Class (Tuesdays & Thursdays, $70)

Vocabulary & Idioms Class (Wednesdays, $50)

Are you a returning student? (Were you a student at Park Street's ESL program before?) *

Yes

If "Yes," which class were you in previously? (Level 1, 2, etc.)

U.S. Phone Number *

U.S. Address *

(Street Name, Apartment Number, City, Zip Code)

Gender *

Male

Female

Birth Date

YYYY

Religion

Are you married?

Yes

Clear selection

Home Country *

Home Country Address

(Only for temporary visa holders)

Visa Type

Arrived in Boston On:

YYYY

Leaving Boston on:

YYYY

Employer or School

(Please fill in the name of University or Research Hospital or Company in the U.S.)

Department

Degree Program

(If you are studying or working in a university or a research hospital, please fill in for example - B.A., M.A., Ph.D., post-doctoral, visiting scholar, etc.)

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