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English Language Learner Classes Form

Please correct the field(s) marked in red below:

English Language Learners Form

Anticipated Enrollment:
 *
Anticipated Enrollment:
Enter your name:
 *
Enter your name:
Have you ever used a different last name?
Are you a former WhatcomCC Student?
 *
Are you a former WhatcomCC Student?
Gender:
 *
Age and birth date
 *
Age and birth date
Address
 *
Address
Email and phone
 *
Email and phone
Did you graduate high school?
 *
Did you graduate high school?
Primary spoken language
Primary spoken language
Country you were born in
 *
Which race(s) do you consider yourself to be?
 *
Which race(s) do you consider yourself to be?
Are you of Spanish/Hispanic/Latino ethnicity?
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Are you of Spanish/Hispanic/Latino ethnicity?
E-signature and date

You are signing this form electronically. You agree that your signature on this document (hereafter referred to as your “E-Signature”) is as valid as if you signed the document in writing. You attest that the information you have provided is true to the best of your knowledge.

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E-signature and date You are signing this form electronically. You agree that your signature on this document (hereafter referred to as your “E-Signature”) is as valid as if you signed the document in writing. You attest that the information you have provided is true to the best of your knowledge.