ASL-As a Second Language - Information Form for Individual Instruction

ASL-As a Second Language
1922 Exeter Rd
Germantown, TN 38138
ph: 901-270-7527
fax: 901-417-8291
instructor@ASLasl.com

Information Form for Individual Instruction

Small classes just not your cup of tea? No problemo. However, additional information is needed for enrollment in individual instruction.

Know that instruction is $60/hour. You will determine how many hours per month (up to 8) you wish to sign up for.

Once your submission has been reviewed and approved for individual instruction, you will be emailed an invoice via PayPal.

By providing the information on this survey, a better determination can be made regarding:

*First Name:

*Last Name:

*Email:

*Approximate age of ASL student?

Under age 6 Age 7 - 13 Age 14 - 19 Over age 20

*If under age 19, at what grade level is the child functioning in English?

Example: student is age 12 but English skills are delayed at a 3rd grade level.

*ZIP/Postal Code of location you wish to receive instruction:

If outside of zip code 38138 (Germantown) travel charges will be applied to total registration fee.

Approximate signing level?

Visit this page of the website: http://www.aslasl.com/choosing_a_class

Place your signing level in the "Anything Else I Need to Know" box below.

*Any additonal folks learning to sign with primary ASL student?

No, just the one student Student + one other (add $15/hour) Student + two others (add $25/hour)

This type of instruction is not available beyond two additional people.

*Approximately how many hours of instruction per month are you interested in receiving?

2 hours/month (bi-weekly) 4 hours/month (weekly) 8 hours/month (semi-weekly)

Enrollment will take place on a month-by-month basis as your instructional needs may change.

*Please offer a brief explanation as to why you need to learn to sign.

Anything else I need to know?? :)

Submit Your Message:

ASL-As a Second Language
1922 Exeter Rd
Germantown, TN 38138
ph: 901-270-7527
fax: 901-417-8291
instructor@ASLasl.com