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One-To-One Learning, INC
English Classes Pre-Registration Form / Formulario de preinscripción de clases de inglés
640 N. Midland Ave, Nyack, NY 10960
email: onetoonelearninginc@gmail.com
Phone No. 845-512-8176
In-Person Classes (Mon & Wed 8:00 PM to 9:30 PM) /
Clases presenciales (lunes y miércoles de 8:00 p.m. a 9:30 p.m.)
Name and Last Name / Nombre y apellido
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First Name
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Last Name
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Your Date of Birth / Tu fecha de nacimiento
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Address / Dirección
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Address Line 1
Address Line 2
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City
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State
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Zip
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Telephone No. / Número de teléfono
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Email / Correo electrónico
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Country of Origin / País de origen
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Your transportation / Tu transporte
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My own car / Mi propio automóvil
Community Van / Van comunitaria
Public bus / Autobús público
A friend drives me / Un amigo/a me trae
Walking / Caminando
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What type of transportation would you use to come to class? / ¿Qué tipo de transporte usarías para venir a clase?
License Plate (car) / Número de placas (carro)
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Relatives in the Program?/Familiar en el programa?
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Yes / Sí
No / No
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Do you have a relative who attends this program? / ¿Tienes algún familiar que asiste a este programa?
You will attend class / Dias que asistirás a clase
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Mondays / Los lunes
Wednesdays / Los miércoles
Both days / Ambos días
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Your level of Education / Tu nivel de educación
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Primary or Elementary School / Escuela Primaria
Middle School / Escuela Secundaria
High School / Escuela Preparatoria
University / Universidad
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Choose only the highest level of education you attained / Elije solo el nivel de educación más alto que obtuviste
Click all you do / Di todo lo que puedas hacer
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I read in own language / Yo leo en mi propio idioma
I write in own language / Yo escribo en mi propio idioma
I know the English alphabet / Yo me se el alfabeto inglés.
I know the numbers in English / Yo me se los números en inglés.
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Your level of English / Tu nivel de inglés
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Beginner / Principiante
Ready to read and Write / Listo para leer y escribir
Pre-GED
GED
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GED refers to a General Education Development diploma which is equivalent to a high school diploma. / GED se refiere a un diploma de Desarrollo de Educación General que equivale a un diploma de escuela preparatoria (high school).
Will your children attend? /¿Asistirán tus hijos?
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Yes / Sí
No/ No
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If your answer is yes, please write the names and ages of your children below accordingly. / Si su respuesta es sí, escriba los nombres y edades de sus hijos a continuación.
Name of your child (1) / Nombre de tu hijo/a (1)
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Write the names and date of birth of your children one by one / Escriba los nombres y fecha de nacimiento de sus hijos uno a uno
Age of Child (1) / Edad de tu hijo/a (1)
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0 to 1yrd old / De 0 a 1 año
2 yrs old / 2 años
3 yrs old / 3 años
4 yrs old / 4 años
5 yrs old / 5 años
6 yrs old / 6 años
7 yrs old / 7 años
8 yrs old / 8 años
9 yrs old / 9 años
10 yrs old / 10 años
11 yrs old / 11 años
12 yrs old / 12 años
13 yrs old / 13 años
14 yrs old / 14 años
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Name of your child (2) / Nombre de tu hijo/a (2)
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Age of Child (2) / Edad de tu hijo/a (2)
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0 to 1yrd old / De 0 a 1 año
2 yrs old / 2 años
3 yrs old / 3 años
4 yrs old / 4 años
5 yrs old / 5 años
6 yrs old / 6 años
7 yrs old / 7 años
8 yrs old / 8 años
9 yrs old / 9 años
10 yrs old / 10 años
11 yrs old / 11 años
12 yrs old / 12 años
13 yrs old / 13 años
14 yrs old / 14 años
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Name of your child (3) / Nombre de tu hijo/a (3)
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Age of Child (3) / Edad de tu hijo/a (3)
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0 to 1yrd old / De 0 a 1 año
2 yrs old / 2 años
3 yrs old / 3 años
4 yrs old / 4 años
5 yrs old / 5 años
6 yrs old / 6 años
7 yrs old / 7 años
8 yrs old / 8 años
9 yrs old / 9 años
10 yrs old / 10 años
11 yrs old / 11 años
12 yrs old / 12 años
13 yrs old / 13 años
14 yrs old / 14 años
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Name of your child (4) / Nombre de tu hijo/a (4)
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Age of Child (4) / Edad de tu hijo/a (4)
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0 to 1yrd old / De 0 a 1 año
2 yrs old / 2 años
3 yrs old / 3 años
4 yrs old / 4 años
5 yrs old / 5 años
6 yrs old / 6 años
7 yrs old / 7 años
8 yrs old / 8 años
9 yrs old / 9 años
10 yrs old / 10 años
11 yrs old / 11 años
12 yrs old / 12 años
13 yrs old / 13 años
14 yrs old / 14 años
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Your teacher in June '24 / Su maestro(a) Junio '24
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Who was your teacher in June 2024? /¿Quién fue tu maestro(a) en junio de 2024?
Vaccinated against COVID?/¿Vacunado contra COVID?
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Yes / Sí
No/ No
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How did you find us? /¿Cómo se enteró de nosotros?
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Internet Search (Google) / Búsqueda en Internet (Google)
Church / Iglesia
Community Center / Centro Comunitario
Friend or Relative / Amigo o pariente
One to One Alumni / Ex-alumnos de "One to One"
Facebook
Instagram
Other means / Otro medio
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