Portuguese Registration Form Student InformationName* First Last Pronouns For example: She/her, He/him, They/them, etc.Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code County*HampshireFranklinHampdenBerkshireOtherEmail* Please add heather@ili.edu to your contacts to be sure your receive our confirmation emails. Check your spam folder if you do not hear from us.Phone*Best number to reach you in case of cancellations.How did you hear about us? I want to know what's happening at ILI!*We send out monthly newsletters about our school programs, opportunities, general news, helpful study tips, occasional reminders to register for new classes and more. We never share our mailing list. No, thanks, not right now. Portuguese Online Course OptionsChoose your semester.*Spring and Fall courses meet once weekly for 12 weeks. Summer and Winter courses meet twice weekly for 6 weeks.Fall: 12-Week Program, September 21-December 14, 2023 (Cost: $429)Winter 2024: 6-Week Program, Date: Jan. 22-Mar 4, 2024 (Cost: $429)Spring 2024: 12-Week Program, Date: Mar 26-June 13,2024 (Cost: $429)Summer 2024: 6-Week Program, Date: July 8-Aug 15, 2024 (Cost: $429)Please choose your class LevelLevel 1: Tuesday, 5-6:30pm (online only)Level 2: Tuesday, 7-8:30pm (online only)Students are placed according to their speaking level. If you are unsure of your level, please contact Samira at samira@ili.edu to schedule an assessment.Refund and Privacy Policy* By checking this box, I confirm that I have read ILI’s refund policy and privacy policy. Please review ILI’s refund policy and privacy policy.CommentsPlease enter the name of your class/es or any special comments you may have.PaymentTotal $0.00 Credit Card*Feed Required: To use the Stripe field, please create a Stripe feed for this form. EmailThis field is for validation purposes and should be left unchanged. Δ