Education ELT READY Form

EDUCATION ELT READY FORM

Purpose: This ELT READY Form documents student eligibility, language background, placement assessment results, program enrollment preferences, required accommodations and consents necessary for enrollment in the English Language Training (ELT) program. Completion of this form authorizes the program to evaluate placement, collect and retain educational records necessary for instruction and funding, and to take limited emergency action as described below.

Student Information

Student is under 18 years of age Yes

Parent / Guardian (If Student is Minor)

Program Enrollment Preferences

Desired ELT Track (select appropriate boxes) Beginner Intermediate Advanced Academic English Business English

Preferred Payment Plan Full payment at enrollment Installment plan (subject to approval) Scholarship / Financial assistance requested

Proficiency Assessment & Placement

The examiner will evaluate the student and recommend placement. The program's placement decision is based on assessment results and classroom availability and is final for the initial placement term.

Accommodations, Medical & Emergency Contact

Consent, Data Use & Policies

I certify that the information provided on this form is complete and accurate to the best of my knowledge. I authorize the ELT program to conduct assessments necessary for initial placement and to use assessment and enrollment records for program administration, instruction, internal reporting, and compliance with funding requirements. Data will be retained in the student's educational record in accordance with program policy.

I consent to assessment, placement testing and the use of assessment results for program placement and instructional planning.

I consent to the collection and retention of educational records and program data as described above.

Fees, Deposits and Cancellation: Enrollment requires payment of the required deposit or tuition as specified by the program. Deposits are non-refundable. Cancellation less than 14 calendar days prior to the scheduled start date may result in forfeiture of fees. Placement is confirmed upon receipt of required payment and completed documentation.

I acknowledge and accept the stated fee, deposit and cancellation policy.

Emergency Medical Authorization: In the event of an emergency, I authorize program staff to obtain medical treatment for the student when I cannot be reached. I agree to be financially responsible for such care and any transportation required.

I authorize emergency medical treatment as described above.

Release and Liability: The program makes reasonable efforts to provide a safe learning environment. By signing, I release the program from liability for loss or injury arising from participation except where caused by the program's willful misconduct or gross negligence.

Photographs and Recordings: I grant permission for photographs, audio or video recordings of the student taken as part of program activities to be used for educational, promotional, or archival purposes unless I otherwise indicate in writing.

I consent to the use of photographs, audio and video recordings as described above.

Acknowledgment and Certification

By signing below, I certify under penalty of program review that the information on this ELT READY Form is true and complete. I understand that falsification or omission of material information may result in denial of enrollment or dismissal from the program. I further acknowledge that placement recommendations are based on the assessment recorded on this form.

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