Free English Classes in Thompson Personal Information First Name Last Name Status in Canada Country of origin Permanent Resident or Refugee Landing Date:____________________ Canadian Citizen Work Visa/ Student Visa Refugee Claimant Languages spoken Occupation in country of origin Occupation in Canada Years of education Years in Canada Contact Information E-mail Phone Town/City Cell phone ESL history and preferences Yes No Have you taken any ESL classes in Canada? School: If yes, when? _______________________ Yes No Have you taken a Canadian Language Levels: L:______ S:_______ R: _______ W:_______ Benchmark Placement Test? IELTS TOEFL If yes, when? _______________________ CanTEST Have you ever taken a one of the Levels: L:______ S:_______ R: _______ W:_______ other following language tests? Yes No Would you be interested in attending English classes in Thompson? When would you like to attend classes? Morning Afternoon Evening more than 3 days a How often would you like to attend classes? 2 days a week 3 days a week week How long would you like the classes to be 2 hours 3 hours More How many children do List ages of your Do you require childcare for classes Yes No you have? children: For more information, please email us at or visit our website at
Free English Classes in Thompson Personal Information First Name Last Name Status in Canada Permanent Resident or Refugee Landing Date:____________________ Canadian Citizen Work Visa/ Student Visa Refugee Claimant Country of origin Languages spoken Occupation in country of origin Occupation in Canada Years of education Years in Canada Contact Information E-mail Phone Town/City Cell phone ESL history and preferences Have you taken any ESL classes in Canada? Yes No School: Have you taken a Canadian Language Benchmark Placement Test? Yes No If yes, when? _______________________ Levels: L:______ S:_______ R: _______ W:_______ Have you ever taken a one of the following language tests? IELTS TOEFL CanTEST other If yes, when? _______________________ Levels: L:______ S:_______ R: _______ W:_______ Would you be interested in attending English classes in Thompson? Yes No When would you like to attend classes? Morning Afternoon Evening How often would you like to attend classes? 2 days a week 3 days a week more than 3 days a week How long would you like the classes to be 2 hours 3 hours More Do you require childcare for classes Yes No How many children do you have? List ages of your children: For more information, please email us at or visit our website at