MLC 3-Week Enrollment Form

Please carefully complete this form to register for MLC classes. If you have any questions, please email info@englishclasses.com. Thank you!

Your Email*
Name*
First Name / Given Name Family Name
Date of Birth*
Gender*
- Female
- Male
Address*
Please enter the mailing address of where you live, including street address, apartment number, city, postal code (if applicable), and country

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Native Country*
(If in U.S.) U.S. Phone Number
Please upload a picture of a government-issued ID, such as passport, driver's license, or state ID.*
Your full name and picture must be visible in the picture.
Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 10 MB.
F1 VISA STUDENTS ONLY: Please upload a picture of your F1 visa.
Your full name and picture must be visible in the picture.
Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 10 MB.
MLC publishes photographs and videos of students/staff for our website, social media, or other forms of communication. Please select an option below:*
- I DO NOT want MLC to use photos/videos that include me.
- I GIVE PERMISSION to MLC to use photos/videos that include me.

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