FOCUS ESL Registration Form

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FOCUS ESL Registration Form - 2021 Fall Term

We're looking forward to seeing you this fall! Some of our classes and activities this fall will be in-person, while some will continue to meet virtually, via Zoom. AT THIS TIME, MASKS ARE REQUIRED FOR ALL IN-PERSON CLASSES AND ACTIVITIES. We will let you know if this changes.

Fall Term classes will begin on September 21, 2021, and end on December 16, 2021.

Please fill out this registration form and submit it as soon as possible. Soon after registration, you will receive an email from us. In that email, we will give you more information, including how to pay for tuition.

This is not a Conversational English class registration. REGISTRATION FOR CONVERSATIONAL ENGLISH IS IN PERSON ONLY on Thursday, September 16 from 9:30 to 11:30 AM at Park Street Church, #1 Park Street, Boston, MA 02108.

Please contact Karen Patschke, our ESL Coordinator, at kpatschke@parkstreet.org if you have any questions.

Email *

Your Family Name (Last Name) *

Your First Name *

Which class(es) and/or activities would you like to register for? *See www.parkstreet.org/ESL for times and descriptions of classes and activities. *

English Vocabulary (Wednesdays, $50) *for students with intermediate or advanced language proficiency

American Culture and Conversation (Fridays, $50)

Hope for Today! (Tuesdays, FREE)

International Weekly Woman's Tea (Wednesdays, FREE) *Please also register at tinyurl.com/2jz8hvw9.

Language Partners (Weekly, $50)

Professional Communications Workshop (Fridays, $80) *for students with intermediate or advanced language proficiency. Please email your resume or CV and writing samples to procomm@parkstreet.org.

Required

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 *

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.)

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

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