Registration Form for ELL Center Classes 2025-2026

Registration Form for ELL Center Classes 2025-2026
Email*
example@example.com
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Country of Origin (native country)*
Native Language (home language)*
How many of your children go to school*

1234567
Schools my children attend*

Preschool at ECC D68Pre-K at ECC D68Devonshire, D68Highland, D68Stenson, D68Old Orchard Junior High, D68Fairview, D72East Prairie, D73Meyer, D73.5Middleton, D73.5McCracken. D73.5Niles North, D219Niles West, D219Other
Please register me for (Check each class that you want to register for. You can register for more than one class)*

ESL1ESL2/3ESL4/5ESL6ESLCONV-Conversation ClassESLREAD/WRT-Reading and Writing WorkshopCOMP1COMP2COMP3CTZN-Citizenship Exam HelpGGLCERT-Google Career CertificatesELL Literacy Circle
How did you hear about ELL Center classes*

I am a past studentemail from Centeremail from SchoolELL Center websiteInformation from friendInformation from schoolOther
I need childcare for this class. (Childcare is only for children 3+ yrs)*
I need transportation. *
Should be Empty: