Online Learning Academy

Student Intake Form

Welcome to the AWC Online Learning Academy. Please complete this form to enroll in English language classes. All information is kept confidential and used only to support your learning.

Personal Information

First Name *Last Name *Date of Birth *Country / City of Residence *WhatsApp Number (if available)Email Address (if available)Emergency Contact / Guardian Name *

Educational Background

Highest Level of Education Completed *

Are you currently enrolled in any other educational program? *

YesNo

English Level & Goals

Current English Level *

Beginner: I know very little or no EnglishElementary: I know basic words and phrasesIntermediate: I can hold simple conversationsAdvanced: I am fairly fluent but want to improve

Why do you want to learn English? (select all that apply) *

To continue my educationTo communicate with mentors or international organizationsTo apply for scholarships or universities abroadPersonal developmentOther

What do you hope to achieve in the next 6 months? *

Access & Availability

Do you have access to a device for online classes? *

SmartphoneLaptop / ComputerTabletNo device

Internet access? *

Reliable internet at homeMobile data onlyLimited / unreliableNo internet access

Preferred class times (select all that apply)

MorningAfternoonEveningWeekend only

Safety & Privacy

Is it safe for you to attend online classes? *

Yes, fullyYes, with some precautionsI need guidance on staying safe online

Do you need your participation to remain private? *

YesNo

Consent

Afghan Women Collective collects this information solely to enroll and support you in our programs. Your information will never be shared with anyone outside AWC without your consent. You may withdraw from the program at any time.

I understand and agree to the above *

Student Signature / Name *Date *

Afghan Women Collective. Your information is kept confidential and used only to support our programs.