Registration Order Number First Name * Family Name * Street Address * City, Province * Postal Code * Home Phone Cell Phone * Email * Date of Birth * (yyyy,mm,dd) Gender * Please select one Male Female Country of Origin * Immigration Status * Please select one Refugee Claimant Permanent Resident Work Permit Student Permit Citizenship Other First Language * Other Language(s) How did you find E-STARS? Please select one Internet Friends Website Years of Education * Please select one 9 Years 12 Years 16 Years or more Income Level * Please select one Under $15,000 $15,001 to $30,000 Over $30,000 Are you working now? * Please select one Yes No Are you looking for a job? * Please select one Yes No CLB Level * (Listening, Speaking, Reading, Writing) English level without CLB * Please select one Beginner High Beginner Intermediate Advanced Others Did you write IELTS or CELPIP test before? * Yes No If Yes, what is your scores? (Listening, Speaking, Reading, Writing) What is your availability? * Please select one Morning Afternoon Evening Weekend Others I can attend classes only in the Would you like to attend Online Classes or In Person Classes? * Please select one Online In Person Both Online and In Person I would like to attend Please share with us what your goal is. * To pass the professional English Language Proficiency Test required by my profession To meet the English Language requirement for PR application To pass my Canadian Citizenship Test To improve my communication skills at workplace To live independently in Canada Others Do you know how to use a computer? * Please select one Yes No When are you going to write your English Test, if you are going to? * Please select one Next month In 3 months In 6 months In next year When do you plan to write your test? * Would you like to have an one-on-one tutorial? * Please select one Yes No Can you write two paragraphs about yourself, if you would like to?
