Fall of 2024 English Class (ELL/ESL) Registration

Please fill in all information to the best of your ability.

There are two class options;

MONDAY MORNINGS 8:30 AM - 10:00 AM
September 9 - November 18, 2024

TUESDAY EVENINGS 6:30 PM - 8:00 PM
September 10 - November 19, 2024

English Classes will be held at the International Friendship Center located on the lower level of Christ Lutheran Church in Pewaukee (W240 N3103 Pewaukee Rd., Pewaukee, WI 53072).

Por favor complete toda la información lo mejor que pueda.

Hay dos opciones de clases;

LUNES POR LA MAÑANA 8:30 A. M. - 10:00 A. M

9 de septiembre - 18 de noviembre de 2024

MARTES POR LA TARDE 6:30 PM - 8:00 PM

10 de septiembre - 12 de noviembre de 204

Las clases de inglés se llevarán a cabo en el Centro de Amistad Internacional ubicado en el nivel inferior de la Iglesia Luterana de Cristo en Pewaukee (W240 N3103 Pewaukee Rd., Pewaukee, WI 53072).

براہ کرم اپنی بہترین صلاحیت کے مطابق تمام معلومات پُر کریں۔

دو قسم کے اختیارات ہیں؛

پیر کی صبح
8:30 AM - 10:00 AM

9 ستمبر - 18 نومبر، 2024

6:30 PM - 8:00 PM
10 ستمبر - 12 نومبر، 2024

پیوکی میں کرائسٹ لوتھرن چرچ کی نچلی سطح پر واقع انٹرنیشنل فرینڈشپ سینٹر میں انگریزی کی کلاسیں منعقد کی جائیں گی۔

Name / Nombre / نام*

First /Nombre de pila /پہلا نام Last / Apellido / آخری نام

Gender / Género / صنف*

MaleFemale

Date of Birth / Fecha de nacimiento / پیدائش کی تاریخ*

Country of Origin / País de origen / پیدائشی ملک*

Phone Number / Número de teléfono / فون نمبر*

Area Code / Codigo de AREA /علاقے کا کوڈ Phone Number / Número de teléfono /فون نمبر

Do you use texting? / ¿Usas mensajes de texto? / کیا آپ ٹیکسٹنگ کا استعمال کرتے ہیں؟*

Yes / Sí / جی ہاںNo / نہیں

Email / Correo electrónico / ای میل*

example@example.com

Address / DIRECCIÓN / پتہ*

Street / Calle / گلی

Street Address Line 2

City / ciudad / شہرState / estado / حالت

Zip Code / código postal / زپ کوڈ

Rate your English level

BeginnerIntermediateAdvanced

Are you interested in Citizenship classes?

YesNo

Please Select Class Option You Prefer / Seleccione la opción de clase que prefiera / براہ کرم اپنی پسند کے کلاس آپشن کو منتخب کریں۔*

8:30-10:00 AM Monday Mornings / Los lunes por la mañana / پیر کی صبح6:30-8:00 PM Tuesday Evenings / Martes por la noche / منگل کی شام

I acknowledge that I have read and understand the disclaimers and waivers below. *WAIVER & PHOTO PERMISSION: The adults and children who participate in the Christ Pewaukee International Friendship Center programs and activities located on the property acknowledges that there are dangers and risks of injury inherent in physical activities, but grants permission to participate in said activities. In addition, the undersigned gives the church staff and IFC volunteers permission to photograph the adult and children to use those photos in print publications and websites. THEREFORE, the undersigned, for and in consideration of the opportunity to participate in IFC programs and activities and for other good and valuable consideration, does hereby accept full responsibility for liability and cost of treatment of injury/illness to the below registered person(s). The undersigned does hereby release the teachers, assistants, property owners, pastors, and church staff from all liability resulting from negligence and agrees to hold them harmless for any injuries, illness, and/or damages that they are their children may sustain arising out of the activities inherent in a program of this type. The undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned, and that this release contains the entire agreement between the parties hereto, and that the terms of this release are contractual in nature and are not a mere recital. By selecting "yes" below, I am stating that I have read and understood the above statement, and that I agree with its terms. I also understand that entering my name constitutes a legally-binding signature.*

Yes / Si / جی ہاں

Do you have children that would require supervision during class? / ¿Tiene niños que requerirían supervisión durante la clase?*

Yes / Si / جی ہاںNo / نہیں

What are their names and ages? / ¿Cuáles son sus nombres y edades? / ان کے نام اور عمریں کیا ہیں؟

	First Name	Last Name	Date of Birth	Age / Edad
Child 1
Child 2
Child 3
Child 4

Leave additional comments here: blanks

Do you have any allergies?

YesNo

List your allergies.

English Classes Registration / Registro / اندراج