English Literacy - Registration Form

Please read each question very carefully to understand what is being asked. Please circle your answers to each item:

Tanpri li chak kesyon ak anpil atansyon. Asire w ke ou konprann say yo mande yo. Antoure repons ki bon yo pou chak sak kesyon yo

STUDENT COMMITMENT STATEMENT:

Understanding how to read and write in English is very important to me. If allowed to enroll in Adult Education, I will attend regularly, and I will work diligently to improve my skills. I pledge to conduct myself in a responsible manner in the Adult Education program and abide by the Adult Education Students guidelines. By signing this form, I certify that I have given full consent to participate in this class and that I am at least 18 years old. I also understand that my information can be used for research, website, and data collection purposes only, and my personal information will not be disclosed to anyone outside of the organization’s research team.

DEKLARASYON ANGAJMAN ELÈV LA:

Konprann kijan pou li ak ekri anglè se yon bagay ki enpòtan anpil pou mwen. Si yo pèmèt mwen enskri nan pwogram Edikasyon pou granmoun nan, mwen pran angajman pou mwen vini chak lè gen klas, e mwen pral travay pou mwen amelyore kapasite mwen yo. Mwen angaje tèt mwen nan yon fason responsab nan pwogram Edikasyon pou granmoun nan e mwen pral respekte Gid Elèv Edikasyon Granmoun nan. Lè mwen siyen fòm sa a, mwen sètifye ke mwen bay konsantman pou mwen patisipe nan klas sa, e mwen genyen omwen 18 lane. Mwen konprann tou ke done mwen yo ka sèvi pou rechèch, sit entènèt, ak koleksyon done sèlman, e ke done pèsonèl mwen pa pral divulge bay okenn moun ki pa nan ekrip rechèch òganizasyon an.

I have read this form and understand the consent / Mwen li fòm nan e mwen konprann angajman mwen yo