College Admissions Form

Work and Education

Please complete this form to complete your enrollment for classes.
First language learned *
Languages Spoken *
Please list them
Highest level of Education *
Current Employer/Job/Occupation *
Example: Construction, cleaning houses, Chick-fil-a, student, driver, notary, government, homemaker, etc
Previous Occupation in your Country*
Example: student, lawyer, construction, factory, doctor, farming, teacher, homemaker, artist, etc
How long have you been living in the United States of America?*
Did you come to the USA as a refugee or asylee with an I-94?*

Photo Consent

WINTER cycle 2026 ( January 20- April 10) "By signing this form, I give Connect Language Center/WR permission to use pictures with me in them or other information, to publically share about the good things that are happening here. This includes possible use on the Instagram/social media, newsletters/printed material, or the website. I understand I will not get paid for any pictures with me in them, and I release the CLC/World Relief from any future claims or liability from using the above"
I give permission for Connect Language Center/WR*

YESNO
Signature*

Clear

Payment to join classes

Please complete your payment to submit your registration. This payment will secure your spot into a group for English classes or Private Lessons. Please note that to open a class we will need at least 6 students. If the class does not make, we will proceed to reimburse your money.

How do you want to pay? Please select one of the options bellow: *

Pay with your credit cardEnter description

$220.00

Pay with CASHText us at 901 295 8874 to coordinate coming in to pay.

$ Free

Total

$0.00

Registration Form