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English (US)
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FY24 ABCD ESOL Application
Learn English for free with ABCD!
Today's Date
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Month
-
Day
Year
Date
Name
*
First Name
Last Name
What is your date of birth?
*
January
February
March
April
May
June
July
August
September
October
November
December
Month
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1927
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1925
1924
1923
1922
1921
1920
Year
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Gender
*
Female
Male
Non-binary
Prefer not to say
Ethnicity
*
Hispanic or Latinx
Non-hispanic or Latinx
Race (Choose all that apply)
*
Black / African-American
White
American Indian / Native American
Asian
Pacific Islander or Native of Hawaii
What is your country of origin?
*
What is your native language?
*
In what year did you arrive in the United States?
*
(YYYY)
Back
Next
Do you have children who are preschool to elementary school age?
*
Yes
No
If not, do you take care of preschool or elementary aged children?
*
Yes
No
Back
Next
What are the dates of birth of the children? (MM/DD/YY)
*
Do they attend Head Start daycare?
*
Yes
No
If yes, which Head Start?
Do they attend Boston Public Schools?
*
Yes
No
If yes, what is the name of their school?
Back
Next
In this program, you will work on your education and career goals. What are your goals for learning English? Choose all that apply.
*
Get a job
Help my children with homework
Get a better job/promotion
Get a raise
Go to university
Enter a job training program
Other
What is your highest level of education?
*
Never attended school
Grades 1-5
Grades 6-8
Grades 9-12, without graduating
Secondary school diploma or alternate credential (HiSet/GED)
Some post secondary education, no degree
Post secondary or professional degree
What was your job in your country?
If you did not work in your country, please type N/A
Do you have a SSN or work authorization?
*
Yes
No
Prefer not to answer
What is your work status?
*
Employed full-time (30 hours or more per week)
Employed part-time (less than 30 hours per week)
Unemployed, looking for a job
Unavailable for work
Retired
Please check any/all public assistance you receive:
*
MassHealth
SNAP (EBT / Food Stamps)
WIC
SSI
TAFDC
EAEDC
I do not receive any of these.
Back
Next
What is your job?
*
What is the name of your company?
*
How many hours do you work each week?
*
What is your work schedule?
*
Back
Next
I have internet / wifi in my home.
*
Yes
No
I'm not sure.
Check all that apply
*
I have a computer.
I have a laptop.
I have a Chromebook.
I have a tablet.
I have a smartphone.
I have a printer in my home.
I don't have any of these.
What computer skills do you have? Check all that apply.
*
I can use email.
I can use Zoom.
I can use Microsoft Word, Powerpoint, etc.
I can use the internet to make an appointment, use social media, etc.
I can not do any of these.
Back
Next
When are you available for classes?
*
Mornings (9:30AM - 12:30PM)
Afternoons (1:30PM - 4:30PM)
None of the above
Do you prefer to take classes online, or in-person?
*
Online
In-person
Either online or in-person
Back
Next
In which office would you like to take classes?
*
ABCD Parker Hill/Fenway (714 Parker Street, Roxbury, MA)
ABCD Roslindale (19 Corinth St, Roslindale MA)
ABCD Mattapan
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