Contact Name: First & Family *Preferred NameNickname, English Name, Name for shortEmail Address *Phone *I particularly want help with:SpeakingListeningReadingWritingGrammarComprehensive (all)EnglishSocial StudiesCanadian CultureOtherIf other selected, please explain:Language Self-AssessmentPlease provide what you think is your ability for each of the following areas.SpeakingPlease select1 - Beginner2345 - Intermediate678910 - AdvancedListeningPlease select1 - Beginner2345 - Intermediate678910 - AdvancedReadingPlease select1 - Beginner2345 - Intermediate678910 - AdvancedWritingPlease select1 - Beginner2345 - Intermediate678910 - AdvancedComprehensionPlease select1 - Beginner2345 - Intermediate678910 - AdvancedGrammar LevelPlease select1 - Beginner2345 - Intermediate678910 - AdvancedEnglishPlease select1 - Beginner2345 - Intermediate678910 - AdvancedSocial StudiesPlease select1 - Beginner2345 - Intermediate678910 - AdvancedCanadian CulturePlease select1 - Beginner2345 - Intermediate678910 - AdvancedPrefered day(s) for lesson(s)MondayTuesdayWednesdayThursdayFridaySaturdayPreferred number of lessons per weekDays per weekPrefered lesson timeHours-120102030405060708091011Minutes-0030AMPMPrefered lesson lengthReason(s) for wanting lessonsDaily LivingPermanent ResidencyCitizenshipAcademicSpeaking1 - Beginner2345 - Intermediate6789 - Advanced10Please tell me a little bit about yourself: *Send Message
