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FTNDC - Student Registration Form - Spring 2023
Complete the student registration form.
If you will bring children with you to class, complete a childcare registration form for each child you will bring to class.
Do you need help? Please send a message to 571-766-8078. We will help you sign up.
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* Indicates required question
What is your first name?
*
Your answer
What is your last name?
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Your answer
What is your gender?
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Female
Male
What is your cell phone number?
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Your answer
WhatsApp Number
Your answer
Email Address (If you don't use email, write n/a.)
Your answer
Street Address (Ex. 123 Main Street Apt. 104)
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
If you are completing this form for a friend or family member, please enter you name and phone number here. We will contact you to help us schedule a call with you and the student.
Your answer
Which is true for you?
*
I am a new student. This is my first time studying English with For the Nations.
I am a returning student. This is NOT my first time studying English with For the Nations.
When & where can you study English? Please select all the locations where you can study.
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FAIRFAX - Monday, Wednesday, & Friday - 9:30 - 11:30 AM (Redeeming Grace Church - 5200 Ox Rd, Fairfax, VA 22030)
ALEXANDRIA - Tuesday, Wednesday & Thursday, 9:30 - 11:30 AM (First Baptist Church - 2932 King St, Alexandria, VA 22302)
FALLS CHURCH - Tuesday, Wednesday & Thursday, 1:00 - 3:00 PM (The Falls Church Anglican - 6565 Arlington Blvd, Falls Church, VA 22042)
Required
Will you bring children (0 -5) with you to class?
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Yes
No
If you are bringing children, please list the names and ages of the children you will bring.
Your answer
Which country are you from?
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Your answer
What month and year did you come to the United States? (Example: June 2021)
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Your answer
What is your native language?
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Your answer
How well can you READ in your NATIVE language?
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Very Little
1
2
3
4
5
A lot
How well can you WRITE in your NATIVE language?
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Very Little
1
2
3
4
5
A lot
What other languages do you speak?
Your answer
Have you taken English classes before (in your home country or here)?
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Yes
No
How well can you READ in English?
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Not at all
1
2
3
4
5
Very Well
How well can you WRITE in English?
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Not at all
1
2
3
4
5
Very Well
How well can you SPEAK in English?
Not at all
1
2
3
4
5
Very Well
Clear selection
What is the highest level of education you have completed?
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No schooling
Grades 1-5
Grades 6-8
Grades 9-12
High School Diploma or GED
Associate’s Degree
Bachelor’s Degree
Master’s Degree
Doctorate
If you have a degree, what subject did you study?
Your answer
What was your job in your home country?
Your answer
Do you have a job now?
*
Yes
No
If yes, what is your job?
Your answer
How did you find our English classes?
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Friend
Resettlement Agency (e.g. LSS, ECDC, LIRS, Catholic Charities)
For the Nations DC Teacher or Volunteer
Website
Flier
Facebook
Other:
Can we use your photo and/or your children’s photo for our website or materials like fliers?
*
Yes, I give permission.
Please ask me first.
No.
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