www.ShanghaiEnglishTeachers.com

name:

email address:

contact phone number:

sex: | male | female |

date of birth:

job title:

industry:

education level: | high school| university|MBA| post-graduate|

English level: | beginner|pre-intermediate| intermediate| upper-intermediate|advanced|

number of years of English study: select 0 1 2 3 4 5 6 7 8 9 10 >10

number of students interested: select 1 2 3 4 5 6 7 8 9 10 11 - 15 16 - 20 20+

area that you live / work in:

Huai Hai Lu| Nanjing Lu | Luwan| Xuhui|

Jingan|Chang Ning|Putuo|Minhang|

Huangpu|Zhabei|Hongkou|Pudong|other: |

location of study: | student's premises|teacher's class room|

topic of study or service:

• English
• • oral English
• • business English
• • written English
• • other
• Business Topics
• • presentation skills
• • sales
• • marketing
• • other
• Service
• • polishing English writing
• • translating
• • • translation to English
• • interpretation
• other topic not listed [please specify]

course times & duration:

hours / class 1 hours 2 hours 3 hours 4 hours 5 hours 6 hours 7 hours 8 hours 8+ hours | times / week 1x 2x 3x 4x 5x 6x 7x | total hours / week 1 2 3 4 5 6 7 8 9 10 11 12 13 14 14+ |

length of course:

preferred study times:

time	days	mon	tues	weds	thurs	fri	sat	sun
before work	< 9 am
morning	9 - 12 noon
lunch time	11.30 - 1.30
afternoon	1 - 6 pm
evening	5 - 8 pm
other time	enter

I would like to join the English Club: |yes|no|

other information:

please type here