Second Language Acquisition (SLA) Course Registration Form

Second Language Acquisition (SLA) Course Registration Form
Name*

First NameLast Name
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Sending Agency/Organization*
How did you hear about this course?

My sending agencyICCT newsletter or websiteFacebookA friend or colleagueOther
Which SLA course would you like to take?*

SLA for Beginning Learners - $1350SLA for Continuing Learners - $1350Introduction to Language Learning - $850Jump-Start SLA - $450I'm not sure. Please contact me to help me decide.
At what pace would you like to take your SLA for Beginning or Continuing Learners course?*

6 weeks, 15-20 hours per week12 weeks, 7-10 hours per weekNot sureOther
At what pace would you like to take your Introduction to Language Learning course?*

3 weeks, 15-20 hours per week6 weeks, 7-10 hours per weekNot sureOther
At what pace would you like to take your Jump-Start SLA course?*

1 week, 25 hours per week5 weeks, 5 hours per weekNot sureOther
In which month would you like to take your course? *
At the time you take this course, in which time zone OR city and country will you be?*
Would you like to add on language coaching for your first year on the field? (This includes individual and group coaching meetings with an instructor to help you be successful in language learning. $500.)*

YesMaybe; tell me more.No
Would you like to take the Cross-Cultural Living and Ministry course? ($450; 5-6 hours per week for one month.)*

Yes, at the same time as the SLA courseYes, immediately after the SLA course and before arriving on the fieldYes, sometime in the future (when I'm on the field)Maybe; tell me more.No
Where will you be living and when do you plan to get there?*
What language(s) will you be learning?*
Other than English, what other languages do you know, where/how did you learn them, for how long, and how many hours per week? (e.g., Darija for one year in Morocco for approximately 10 hours per week; Spanish is my family's primary language of communication.) *
Have you taken any linguistics courses before? If so, which ones?*
Thank you for your registration. You will receive an email with payment information soon. Once your payment is submitted, you will receive access to your course(s).
Please sign up for a meeting with Dr. Natalie Mullen Leisher, director of ICCT, to discuss further details: https://calendly.com/nataliemullen
Optional Demographic Survey

The following questions are related to your demographic information. ICCT will use this generate statistics for grant applications and subsequent reporting. This information will remain anonymous, and completing this survey has no impact on your registration or acceptance into the course.
Ethnicity

African AmericanAsianBi/Multi-RacialCaucasianHispanic/Latino/aNative American/Alaskan NativeHawaiian/Pacific IslanderOther
Age Range

0-1718-3031-4546-6566+
Should be Empty:

Second Language Acquisition (SLA) Course Registration Form

Thank you for your registration. You will receive an email with payment information soon. Once your payment is submitted, you will receive access to your course(s).

Please sign up for a meeting with Dr. Natalie Mullen Leisher, director of ICCT, to discuss further details: https://calendly.com/nataliemullen

Optional Demographic Survey